Processus ressources humaines dans les Petites et Moyennes Entreprises du Mali : Cas des Etablissements d’Importation et de Vente en Gros des produits pharmaceutiques

While small and medium-sized enterprises (SMEs) make up the bulk of the economic fabric in most countries of the world and contribute more than large enterprises to job creation, the dominant literature tends to maintain that the HR function is emerging, poorly structured and reveals informal practices. This research sheds light on the debates surrounding human resource management processes in Malian SMEs, particularly in the pharmaceutical import and wholesale establishments of Bamako. Three types of processes are identified: recruitment, training and skills development, and finally remuneration. This is a descriptive, cross-sectional and prospective study that lasted 10 months (July 2021-June 2022). A survey was conducted with 28 people, including 15 managers, 5 supervisors and 8 executives. The results show that the companies studied are more frequently putting in place a global policy in terms of recruitment, training and skills development; and thus, gradually, a remuneration system more relevant to the regulations in force and the changes in the economic context has been established. Our results show that there are differences in the practices of the companies, and that there is also a commitment on the part of staff to improve the recruitment process. However, improvements are to be expected, as Human Resources Management functions are devolved to personnel with technical and scientific knowledge. No forward-looking management of jobs and skills has been put in place. This strongly deteriorates the performance in human resources management.   Keywords: Human resources process, Drug import and wholesale establishments, Bamako, Mali. JEL Classification: O15 Paper type: Empirical research.Alors que les petites et moyennes entreprises (PME) constituent l’essentiel du tissu économique dans la plupart des pays du monde et contribuent plus que les grandes entreprises à la création des emplois, la littérature dominante tend à soutenir que la fonction RH y est émergente, peu structurée et révèle des pratiques informelles. Cette recherche apporte un éclairage sur les débats autour des processus de la gestion des ressources humaines dans les PME maliennes notamment dans les établissements d’importation et de vente en gros des produits pharmaceutiques de Bamako. Trois types de processus sont cernés : le recrutement, la formation et le développement des compétences, et enfin la rémunération. Il s’agit d’une étude descriptive transversale et prospective qui a duré 10 mois (Juillet 2021-Juin 2022). Une enquête a été menée auprès de 28 personnes, dont 15 cadres, 5 agents de maîtrises et 8 agents d’exécutions. Les résultats montrent que les entreprises étudiées mettent plus fréquemment en place une politique globale en matière de recrutement, de formation et de développement des compétences ; et ainsi, progressivement, un système de rémunération plus pertinent avec la réglementation en vigueur et les changements au contexte économique se sont instaurés. Nos résultats relèvent des divergences dans les pratiques des sociétés, ils relèvent également un engagement des personnels dans l’amélioration des processus de recrutement. Cependant, des améliorations sont à prévoir, car les fonctions de Gestion des Ressources Humaines sont dévolues à des personnels ayant des connaissances techniques et scientifiques. Aucune gestion prévisionnelle des emplois et des compétences n’est mise en place. Ce qui détériore fortement la performance dans la gestion des ressources humaines.   Mots clés :  Processus ressources humaines, Etablissements d’importation et de vente en gros des médicaments, Bamako, Mali. Classification JEL : O15 Type de l’article : Recherche appliquée

Subclinical Cardiac Dysfunction Is Associated With Extracardiac Organ Damages

Background: Several studies conducted in America or Europe have described major cardiac remodeling and diastolic dysfunction in patients with sickle cell disease (SCD). We aimed at assessing cardiac involvement in SCD in sub-Saharan Africa where SCD is the most prevalent.Methods: In Cameroon, Mali and Senegal, SCD patients and healthy controls of the CADRE study underwent transthoracic echocardiography if aged ≥10 years. The comparison of clinical and echocardiographic features between patients and controls, and the associations between echocardiographic features and the vascular complications of SCD were assessed.Results: 612 SCD patients (483 SS or Sβ0, 99 SC, and 19 Sβ+) and 149 controls were included. The prevalence of dyspnea and congestive heart failure was low and did not differ significantly between patients and controls. While left ventricular ejection fraction did not differ between controls and patients, left and right cardiac chambers were homogeneously more dilated and hypertrophic in patients compared to controls and systemic vascular resistances were lower (p < 0.001 for all comparisons). Three hundred and forty nine SCD patients had extra-cardiac organ damages (stroke, leg ulcer, priapism, microalbuminuria or osteonecrosis). Increased left ventricular mass index, cardiac dilatation, cardiac output, and decreased systemic vascular resistances were associated with a history of at least one SCD-related organ damage after adjustment for confounders.Conclusions: Cardiac dilatation, cardiac output, left ventricular hypertrophy, and systemic vascular resistance are associated with extracardiac SCD complications in patients from sub-Saharan Africa despite a low prevalence of clinical heart failure. The prognostic value of cardiac subclinical involvement in SCD patients deserves further studies

Availability of Drugs for Mothers and Children in Community Health Centers in Commune VI of the Bamako Health District

Introduction: Improving maternal and child health is a worldwide priority. An estimated 8.1 million children under five die each year. Approximately 1,000 women, most of whom live in developing countries, die every day from complications of pregnancy or childbirth. The objective of this work was to assess the availability of mother's and child's medicines at the level of the community health center VI of the Bamako district, Mali. Materials and methods: This were a prospective cross-sectional study which was took place in Bamako in the community health center VI in 12 months over the period from November 2019 to October 2020. We carried out a survey in the 11 community health center VI. Data entry and analysis were performed using SPSS version 21.0 software. Results: In this study, the sex ratio was 2.66. Half of the people surveyed were doctors (50%) who assumed the role of DTC (Technical Director of the Center). As for the profiles of managers, in our sample, accountants were the most represented with a rate of 31.82%. Almost all depot managers have received training in logistics management (86% of cases). 73.00% of Community health centers correctly followed the SDADME (drug supply and distribution master plan). The Community health centers were supplied by other suppliers in the event of a shortage at the PPM (Popular Pharmacy of Mali) with a rate of 86.40%. The total availability rate of medicines for mothers and children was 60%. Breaks were recorded for eight (08) products. The causes mentioned in relation to drug breaks were, among others: non-ordering of drugs, non-availability at the PPM and non-prescription of drugs by providers. Conclusion: This study revealed a good availability of drugs for mother and child. However, we found that some of these drugs were out of stock. These shortages were due either to the non-availability of the PPM store, or to the non-ordering of these products by the Community health centers. Keywords: management, medicine, CSComs, mothers and children, Bamako

Solidarity-based Financing of Health Care Access for the Poor Patients at the University Hospital Point G, Bamako, Mali

Introduction: Almost half of the world's populations do not have access to basic health care. This exclusion mainly affects people living in rural areas, who are nevertheless the most susceptible to diseases. The Medical Assistance Plan allows a marked improvement in access to healthcare by poor patients. It eliminates out of pocket healthcare cost, which normally prevents most of them from accessing health care. Materials and methods: This study was aimed to investigate the accessibility to healthcare for poor patients at the University Hospital Point G. We conducted a 12-month descriptive cross-sectional study from March 2018 to April 2019. Data entry and analysis were performed using SPSS version 21.0. Results: Our study participants we interviewed were aged 30-44 years old in 30.7%, female in 60.7%, and housewives in 46.7%. Our interviewees consulted for consulted for chronic diseases in 79.3%, had no monthly income in 78.7% and obtained the healthcare benefits at no cost to them in 60.7%. The prescriptions costed between 5,000 and 15,000 FCFA in 51.1%, 20252 FCFA on average with a standard deviation of 1340 FCFA. In sum, 59 out of our 150 patients who were eligible for free healthcare had to pay for a contribution either a subsidized cost in 84.7% or a partial purchase in in 15.3%.  Conclusion: The main barriers to healthcare were the chronicity of their diseases and the expensiveness of the healthcare due the level of poverty in the country. Keywords: Solidarity financing, Access to healthcare, poor, CHU Point G / Mal