Comparative study of the primary healthcare systems in China and Mali

Abstract

Background: Community health centres (CHCs) are an important component of the health system in Mali and China. Despite patient support and commitment from the authorities, the management and the quality of care of these structures need to be improved. This research aimed to compare the management style of the relevant boards with users’ satisfaction pertaining to CHC services in Mali and China. Method: Between September 2009-January 2010, a study was conducted in eight CHCs in Mali and in 16 CHCs in China. A total of 480 householders, [60 (Mali) and 320 (China)]; and 24 management committee members (Mali) and 48 management committee members (China) were interviewed. An in-depth interview technique was used on members of the management committee, while a structured interview was carried out to collect data during face-to-face contact with householders in their residences. In residences in which there were two or more households, the first willing householder was interviewed. Questions about the level of satisfaction were coded from 1-5 and ranged from “excellent” to “very bad” respectively. Results: The CHCs in China were managed by the government, whereas in Mali, they were overseen by the local population. The most satisfied people in both countries were those living in the poorest socioeconomic conditions, the elderly, and those who attended the healthcare meetings. Chinese households were more satisfied with the quality of the CHC services than those in Mali. The Chinese management boards proposed standardisation of rules and more funding, whereas those in Mali advocated that government provide more funding and human resources allocation. Conclusion: A high level of satisfaction regarding the CHC services was observed. However, users reported on deficits in the quality of care, whereas management suggested a need for greater resource allocation.

Key words: primary health care system, householders’ satisfaction, management board, China, Mali