Title:
Scaling Up Community-based Surveillance in Mali: The Golden Age of Epidemiological Systems Strengthening

Authors:
Souleymane Sekou Diarra, Nouhoum Telly, Seydou Fomba, Souleymane Togola, Salif Samaké, Moulaye Baby, Assetou Y Dembele, Serge Agb, Oumar Sangho, Sory I Diawara, Hamadoun Sangho, Seydou Doumbia, Carmen M. Camino, Mali

Abstract:

Introduction: Community-Based Surveillance (CBS) in Mali is a cornerstone of early detection of diseases and public health events. It integrates community base surveillance (CBS) and media tracking with digital tools. The Malian system has made progress in its strategic and planning documents, and its level of implementation continues to improve. However, it is necessary to adapt the training for community health workers in each district and to maintain the support and motivation of these key personnel, while ensuring consistency in reporting and better data management.

Materials and Methods: We carried out a qualitative cross-sectional study, based on stakeholder interviews, document analysis, and on-site observations. Six respondents were interviewed at the strategic level (including NGOs) and eleven at the operational level (community health workers). Three interview guides and a group facilitation guide were used for the community health workers.

Results: The results showed that 83.3% of the elements deemed essential for planning include a CBS technical guide providing reliable information for implementation, as well as data collection tools (alerts, priority events) harmonized with CBS at each level. The strengths of the implemented models rely primarily on the strong community involvement in the detection, dissemination of information, and support of the response to epidemics and other public health events. Regarding weaknesses, the results revealed a lack of proper archiving of community health workers' records (notification forms and attendance sheets), and the low education level for some of them prevented them from fully understanding the definitions of cases.

Conclusion: The results demonstrated the existence of a robust system for essential planning elements. In particular, the CBS technical guide provides information on the key steps to follow for CBS implementation. However, there is a need for adapting tools and training to the abilities and capacities of community staff to avoid disenfranchisement and a perception of a top-down initiative.

DOI: http://dx.doi.org/10.51505/ijmshr.2026.10301