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Improving health system organisation in West Africa, through promotion of health policy development based on a network of action-researches leaded by National Public Health Schools

Final Report Summary - AFNET (Improving the health system organisation in West Africa, through promotion of health policy development based on a network of action-researches)

The ultimate aim of the AFNET project was to promote an African process of health policies development based on a top-down and bottom-up complementary approach, through the reinforcement of a network of action researches led by National Public health schools (PHS). It targeted four French-speaking West African countries, namely Benin, Senegal, Burkina Faso and Niger. The overall objective was to support a regional process of action research for continuous improvement of health care quality and health services organisation, with tuberculosis used as an entrance to a better understanding of the health system functioning. The specific objectives of the project were to:
- support knowledge and experience exchanges within a network of French-speaking West African countries;
- generate evidence for decision makers through action research implemented in partnership with professionals working at different levels in the health care system;
- ensure dissemination of action research results at different levels (national, regional, international) to incorporate recommendations issued from the project into health policies to finally promote health policy development.

A series of different activities were planned, namely:
- a first seminar: the participant's knowledge would be enhanced and sharing of experiences would be organised. Based on this, each country would define an action research;
- the action research would be implemented in each country, with the support of the PHS. A peer review by the consortium would be organised after one year to re-orientate the action research if needed, in collaboration with all actors involved;
- a restitution seminar would be organised to exchange results, synthesise acquired knowledge and define diffusion strategies;
- dissemination of the project results leading to their integration into national and regional health policies.

In brief, the action research areas of each of the four countries of concern were the following:
- Benin: The Benin team chose to go into its research question 'how to decrease the rate of people that some care centres lost sight of?', as well as it aimed to consolidate preliminary results obtained by insisting on socio-anthropological aspects.
- Burkina Faso: The purpose of its action-research was to improve the TPM+ screening rate in the 16 pilot care centres of the two health districts chosen through the extension of the diagnose decentralisation and tuberculosis treatment.
- Niger: The purpose of the research was to improve the TPM+ screening rate in the Kaya district, a health region of Dosso.
- Senegal: The central problem identified by Senegal was the abandon rate of tubercular patients and the main strategies implemented were the screening decentralisation, Community directly observed treatment (TDO-Com), improvement of the provider-patient communication provider - patient and targeted home visits.