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"source_node_id": "mli:communes", "target_node_id": "mli:community-health-associations", "relationship": "participates with in commune health commissions", "relationship_family": "network", "display_claim_ids": [ "display-claim:508575e9657f5ef1448abf53" ], "display_source_ids": [ "display-source:MLI:569673225ef657f111c497f0" ], "source_version_ids": [ "display-source-version:f7f336bc63f4c80260d86da1" ], "display_evidence_object_id": "display-claim:508575e9657f5ef1448abf53" }, { "source_node_id": "mli:community-health-associations", "target_node_id": "mli:community-health-centres", "relationship": "was reported to manage local centres through", "relationship_family": "operations", "display_claim_ids": [ "display-claim:9ba8f3e49eeb71a056092805" ], "display_source_ids": [ "display-source:MLI:569673225ef657f111c497f0" ], "source_version_ids": [ "display-source-version:f7f336bc63f4c80260d86da1" ], "display_evidence_object_id": "display-claim:9ba8f3e49eeb71a056092805" } ], "decision_cells": [ { "decision_id": "local-health-centre-management", "decision_label": "Local health-centre management", "actor_label": "Community health associations (ASACO)", "actor_family": "provider", "role": "Reported delegated manager", "constraint": "Historical rural-study finding.", "display_claim_ids": [ "display-claim:36d670bf44fcae8545974e32" ], "display_source_ids": [ "display-source:MLI:569673225ef657f111c497f0" ], "source_version_ids": [ "display-source-version:f7f336bc63f4c80260d86da1" ], "display_evidence_object_id": "display-claim:36d670bf44fcae8545974e32" }, { "decision_id": "local-staffing", "decision_label": "Local staff contracting and incentives", "actor_label": "Communes", "actor_family": "subnational", "role": "Reported local-government role", "constraint": "Described in the study period, not verified as current nationwide.", "display_claim_ids": [ "display-claim:6a1d572c7015df2032d8643a" ], "display_source_ids": [ "display-source:MLI:569673225ef657f111c497f0" ], "source_version_ids": [ "display-source-version:f7f336bc63f4c80260d86da1" ], "display_evidence_object_id": "display-claim:6a1d572c7015df2032d8643a" }, { "decision_id": "training-performance-monitoring", "decision_label": "Training and performance monitoring", "actor_label": "Health districts", "actor_family": "subnational", "role": "Reported district-management role", "constraint": "The source does not give a current formal decision-right table.", "display_claim_ids": [ "display-claim:748b5f0970a48e81886ae02b" ], "display_source_ids": [ "display-source:MLI:569673225ef657f111c497f0" ], "source_version_ids": [ "display-source-version:f7f336bc63f4c80260d86da1" ], "display_evidence_object_id": "display-claim:748b5f0970a48e81886ae02b" } ] }, "title": "Historical devolution involved overlapping local roles", "statement": "A rural-Mali study describes separate commune, ASACO and district-management roles in a historical devolution setting. It does not settle their current national allocation.", "citation": "Dieleman et al. Devolution and human resources in primary healthcare in rural Mali. 2011, Introduction and Discussion.", "url": "https://www.ebi.ac.uk/europepmc/webservices/rest/PMC3119183/fullTextXML", "locator": "Article sections Introduction; Discussion: Decentralization and health services; Downward accountability.", "period": "Historical arrangements described in a 2011 publication", "territory": "Rural Mali, particularly programme experience in Koulikoro", "evidence_mode_candidate": "reported", "verification_source_layer": "research_literature", "coverage_domains": [ "actors", "government_responsibilities", "decision_rights", "autonomy", "primary_care", "networks", "governance" ], "source_version": { "response_sha256": "310cbad74401bd78b1bb3713e580a38644a185bbb7c97bc5e7b466e308cac2e9", "hash_verified": true }, "boundaries": [ "Do not infer present-day, nationwide control over workforce, budgets or service configuration from this historical study." ], "source_references": [ { "title": "Devolution and human resources in primary healthcare in rural Mali", "citation": "Dieleman M, Toonen J, Touré H, Martineau T. Devolution and human resources in primary healthcare in rural Mali. Human Resources for Health. 2011;9:15. doi:10.1186/1478-4491-9-15. https://www.ebi.ac.uk/europepmc/webservices/rest/PMC3119183/fullTextXML", "url": "https://www.ebi.ac.uk/europepmc/webservices/rest/PMC3119183/fullTextXML", "locator": { "locator_type": "article_section_anchor", "sections": [ "Introduction", "Discussion: Decentralization and health services", "Discussion: Downward accountability" ], "source_word_anchor": "delegation of management of health centres to community health associations", "source_word_count": 9 }, "source_version": { "response_sha256": "310cbad74401bd78b1bb3713e580a38644a185bbb7c97bc5e7b466e308cac2e9", "detected_media_type": "application/xml", "hash_verified": true }, "source_projection_id": "country-improvement-source:MLI:devolution-hrh-study-2011", "display_source_id": "display-source:MLI:569673225ef657f111c497f0", "source_version_id": "display-source-version:f7f336bc63f4c80260d86da1" } ], "display_source_ids": [ "display-source:MLI:569673225ef657f111c497f0" ], "source_version_ids": [ "display-source-version:f7f336bc63f4c80260d86da1" ], "display_claim_ids": [ "display-claim:700c36f52714a5510e8c6711", "display-claim:508575e9657f5ef1448abf53", "display-claim:9ba8f3e49eeb71a056092805", "display-claim:36d670bf44fcae8545974e32", "display-claim:6a1d572c7015df2032d8643a", "display-claim:748b5f0970a48e81886ae02b" ], "display_evidence_object_id": "display-claim:700c36f52714a5510e8c6711", "display_eligible": true, "canonical_claim": false, "publication_boundary": "source_linked_typed_mapping_visible_for_annotation_not_a_canonical_claim" }, { "mapping_id": "candidate-mapping:MLI:decision-autonomy:pbf-facility-management-scope", "country_id": "MLI", "mapping_group": "decision_rights_and_autonomy", "target_view": "autonomy", "target_slot": "project-specific-financial-and-management-autonomy", "support_state": "candidate_supported", "annotation_state": "open", "mapping_basis": "World Bank project completion report on performance-based financing", "source_projection_ids": [ "country-improvement-source:MLI:uhc-project-icr-2025" ], "typed_fields": { "reported_discretion": "Participating facilities received PBF resources and increased management autonomy for stated quality-improvement decisions.", "accountability": "The project used facility and community or patient data verification.", "scope": "The source limits the arrangement to project areas and implementation context.", "boundary": "No national autonomy score or uniform facility authority is established." }, "analytical_objects": { "graph_edges": [ { "source_node_id": "mli:pbf-programme", "target_node_id": "mli:community-health-centres", "relationship": "made performance-linked resources available to participating facilities", "relationship_family": "purchasing", "display_claim_ids": [ "display-claim:eaa7e6a6ff1d95d4fbc39b8f" ], "display_source_ids": [ "display-source:MLI:65b83a3a38a5f2ca6c9fd46c" ], "source_version_ids": [ "display-source-version:e8086ff26cf8631ddd9b229a" ], "display_evidence_object_id": "display-claim:eaa7e6a6ff1d95d4fbc39b8f" } ], "autonomy_cells": [ { "dimension": "Financial management", "provider_group": "Primary care", "authority_label": "Project-reported increased management autonomy", "counterpart": "Performance-based financing programme", "display_claim_ids": [ "display-claim:c5d6f396ebbf092c37b0faa3" ], "display_source_ids": [ "display-source:MLI:65b83a3a38a5f2ca6c9fd46c" ], "source_version_ids": [ "display-source-version:e8086ff26cf8631ddd9b229a" ], "display_evidence_object_id": "display-claim:c5d6f396ebbf092c37b0faa3" }, { "dimension": "Operations", "provider_group": "Primary care", "authority_label": "Stated quality-improvement decisions, including hiring", "counterpart": "Project design and verification arrangements", "display_claim_ids": [ "display-claim:5ef98a427996af5f5137e59d" ], "display_source_ids": [ "display-source:MLI:65b83a3a38a5f2ca6c9fd46c" ], "source_version_ids": [ "display-source-version:e8086ff26cf8631ddd9b229a" ], "display_evidence_object_id": "display-claim:5ef98a427996af5f5137e59d" } ] }, "title": "Facility autonomy is reported only within the PBF project context", "statement": "The completion report describes budget-management and selected management autonomy in PBF project areas. It should not be read as a national facility-autonomy classification.", "citation": "World Bank, Mali Accelerating Progress Towards Universal Health Coverage Project ICR, 2025, pp. 3-4.", "url": "https://documents1.worldbank.org/curated/en/099022025110028997/pdf/BOSIB-ec653f3c-9f8d-4765-825b-f00fbd012a14.pdf", "locator": "ICR PDF p. 11, Project background and theory of change, paragraphs 6-7.", "period": "Project prepared 2018; completion report published 2025", "territory": "PBF project areas, scaled to four of eight regions", "evidence_mode_candidate": "observed", "verification_source_layer": "grey_literature", "coverage_domains": [ "autonomy", "primary_care", "facility_data", "utilization", "patient_flows", "governance" ], "source_version": { "file_sha256": "b7ffe9db9974ecb6857670fb2e4e242c01e729f619cdad8e2d256078064c621b", "hash_verified": true }, "boundaries": [ "Do not infer that all facilities receive PBF, retain the same discretion, or have better performance because of this arrangement." ], "source_references": [ { "title": "Mali - Accelerating Progress Towards Universal Health Coverage Project: Implementation Completion and Results Report", "citation": "World Bank. Mali - Accelerating Progress Towards Universal Health Coverage Project (P165534): Implementation Completion and Results Report. 2025. https://documents1.worldbank.org/curated/en/099022025110028997/pdf/BOSIB-ec653f3c-9f8d-4765-825b-f00fbd012a14.pdf", "url": "https://documents1.worldbank.org/curated/en/099022025110028997/pdf/BOSIB-ec653f3c-9f8d-4765-825b-f00fbd012a14.pdf", "locator": { "locator_type": "pdf_page_anchor", "physical_pdf_page": 11, "section": "Project background and theory of change, paragraphs 6-7", "source_word_anchor": "empowers health facilities with autonomy in budget management", "source_word_count": 8 }, "source_version": { "file_sha256": "b7ffe9db9974ecb6857670fb2e4e242c01e729f619cdad8e2d256078064c621b", "response_sha256": "b7ffe9db9974ecb6857670fb2e4e242c01e729f619cdad8e2d256078064c621b", "page_count": 51, "detected_media_type": "application/pdf", "hash_verified": true }, "source_projection_id": "country-improvement-source:MLI:uhc-project-icr-2025", "display_source_id": "display-source:MLI:65b83a3a38a5f2ca6c9fd46c", "source_version_id": "display-source-version:e8086ff26cf8631ddd9b229a" } ], "display_source_ids": [ "display-source:MLI:65b83a3a38a5f2ca6c9fd46c" ], "source_version_ids": [ "display-source-version:e8086ff26cf8631ddd9b229a" ], "display_claim_ids": [ "display-claim:4268af6bc236fcde962c74e3", "display-claim:eaa7e6a6ff1d95d4fbc39b8f", "display-claim:c5d6f396ebbf092c37b0faa3", "display-claim:5ef98a427996af5f5137e59d" ], "display_evidence_object_id": "display-claim:4268af6bc236fcde962c74e3", "display_eligible": true, "canonical_claim": false, "publication_boundary": "source_linked_typed_mapping_visible_for_annotation_not_a_canonical_claim" }, { "mapping_id": "candidate-mapping:MLI:delivery-referrals:formal-pyramid-and-referral-sequence", "country_id": "MLI", "mapping_group": "delivery_and_referrals", "target_view": "referrals", "target_slot": "current-formal-levels-of-referral", "support_state": "candidate_supported", "annotation_state": "open", "mapping_basis": "PS-SNISS 2026-2030 referral-pyramid description, corroborated against the 2019 system description in PS-SNISS 2020-2024", "source_projection_ids": [ "country-improvement-source:MLI:ps-sniss-2026-2030", "country-improvement-source:MLI:ps-sniss-2020-2024" ], "source_references": [ { "title": "Plan stratégique du système national d'information sanitaire et social 2026-2030", "citation": "Ministère de la Santé et du Développement Social, Mali. PS-SNISS 2026-2030. 2026.", "url": "https://www.sante.gov.ml/article-download.php?article=206&slot=1", "locator": { "physical_pdf_pages": [ 11, 12 ] }, "source_version": { "file_sha256": "638df966261c7b168aa6aa64d33a26c6ce6b34cf4b12ced1ef6f16663391a89f", "hash_verified": true }, "source_projection_id": "country-improvement-source:MLI:ps-sniss-2026-2030", "display_source_id": "display-source:MLI:7cef05edfa5f331ed8afc820", "source_version_id": "display-source-version:3a0f0e27d981923b8c1bc695" }, { "title": "Plan stratégique du système national d'information sanitaire et social 2020-2024", "citation": "Ministère de la Santé et du Développement Social, Mali. PS-SNISS 2020-2024. 2021.", "url": "https://files.aho.afro.who.int/afahobckpcontainer/production/files/PS-SNISS_2020-2024_VF_11fev2021.pdf", "locator": { "physical_pdf_pages": [ 19, 20 ] }, "source_version": { "file_sha256": "85a879ba37dc64044b45efb8436e9b7a7c25aa60b3672db6d3a5d1776f5307ff", "hash_verified": true }, "source_projection_id": "country-improvement-source:MLI:ps-sniss-2020-2024", "display_source_id": "display-source:MLI:bd0c3862e382e8f2b708aa21", "source_version_id": "display-source-version:c47e25e446e2f0787904f344" } ], "typed_fields": { "first_contact": "CSCom is stated as the community-level first contact for primary care.", "first_referral": "CSRef is the district-level first referral for conditions not managed at CSCom.", "higher_referral": "Regional and national hospitals provide second and third referral levels respectively.", "boundary": "The stated sequence does not quantify referral completion, delay, bypass or counter-referral." }, "analytical_objects": { "graph_edges": [ { "source_node_id": "mli:community-health-centres", "target_node_id": "mli:reference-health-centres", "relationship": "is the stated first-referral pathway to", "relationship_family": "referral", "display_claim_ids": [ "display-claim:697dea147062aa9b086760b7" ], "display_source_ids": [ "display-source:MLI:7cef05edfa5f331ed8afc820", "display-source:MLI:bd0c3862e382e8f2b708aa21" ], "source_version_ids": [ "display-source-version:3a0f0e27d981923b8c1bc695", "display-source-version:c47e25e446e2f0787904f344" ], "display_evidence_object_id": "display-claim:697dea147062aa9b086760b7" }, { "source_node_id": "mli:reference-health-centres", "target_node_id": "mli:regional-hospitals", "relationship": "refers or evacuates unresolved conditions to", "relationship_family": "referral", "display_claim_ids": [ "display-claim:7f10549106827c7e14b2350a" ], "display_source_ids": [ "display-source:MLI:7cef05edfa5f331ed8afc820", "display-source:MLI:bd0c3862e382e8f2b708aa21" ], "source_version_ids": [ "display-source-version:3a0f0e27d981923b8c1bc695", "display-source-version:c47e25e446e2f0787904f344" ], "display_evidence_object_id": "display-claim:7f10549106827c7e14b2350a" }, { "source_node_id": "mli:regional-hospitals", "target_node_id": "mli:national-hospitals", "relationship": "refers or evacuates unresolved conditions to", "relationship_family": "referral", "display_claim_ids": [ "display-claim:78b149e57feeffa10211b120" ], "display_source_ids": [ "display-source:MLI:7cef05edfa5f331ed8afc820", "display-source:MLI:bd0c3862e382e8f2b708aa21" ], "source_version_ids": [ "display-source-version:3a0f0e27d981923b8c1bc695", "display-source-version:c47e25e446e2f0787904f344" ], "display_evidence_object_id": "display-claim:78b149e57feeffa10211b120" } ] }, "title": "The formal referral pyramid names four levels", "statement": "The current Ministry strategy lays out a CSCom-to-CSRef-to-regional-to-national referral sequence. It is a stated pathway, not an observed patient-flow result.", "citation": "Ministère de la Santé et du Développement Social, PS-SNISS 2026-2030, pp. 11-12.", "url": "https://www.sante.gov.ml/article-download.php?article=206&slot=1", "locator": "PS-SNISS 2026-2030, pp. 11-12, section 4.2.2.1.", "period": "Current system description published 2026; supporting facility context dated 2024", "territory": "Mali", "evidence_mode_candidate": "formal", "verification_source_layer": "official", "coverage_domains": [ "primary_care", "hospital_organization", "referral_design", "networks", "patient_flows", "governance" ], "source_version": { "file_sha256": "638df966261c7b168aa6aa64d33a26c6ce6b34cf4b12ced1ef6f16663391a89f", "hash_verified": true }, "boundaries": [ "Do not infer that every patient follows the sequence or that a formal transfer has clinical capacity, transport, feedback or outcome data." ], "display_source_ids": [ "display-source:MLI:7cef05edfa5f331ed8afc820", "display-source:MLI:bd0c3862e382e8f2b708aa21" ], "source_version_ids": [ "display-source-version:3a0f0e27d981923b8c1bc695", "display-source-version:c47e25e446e2f0787904f344" ], "display_claim_ids": [ "display-claim:a1c9fd07662242d8e2f0cfa1", "display-claim:697dea147062aa9b086760b7", "display-claim:7f10549106827c7e14b2350a", "display-claim:78b149e57feeffa10211b120" ], "display_evidence_object_id": "display-claim:a1c9fd07662242d8e2f0cfa1", "display_eligible": true, "canonical_claim": false, "publication_boundary": "source_linked_typed_mapping_visible_for_annotation_not_a_canonical_claim" }, { "mapping_id": "candidate-mapping:MLI:delivery-referrals:private-provider-referral-boundary", "country_id": "MLI", "mapping_group": "delivery_and_referrals", "target_view": "referrals", "target_slot": "private-provider-referral-in-formal-description", "support_state": "candidate_supported", "annotation_state": "open", "mapping_basis": "PS-SNISS description of private-provider referral destination", "source_projection_ids": [ "country-improvement-source:MLI:ps-sniss-2026-2030" ], "typed_fields": { "private_provider_path": "Private facilities are stated to refer patients to CSRef or regional or national hospital according to urgency.", "boundary": "The source does not give private-provider referral volumes, contracts, compliance or patient experience." }, "analytical_objects": { "graph_edges": [ { "source_node_id": "mli:private-providers", "target_node_id": "mli:reference-health-centres", "relationship": "is stated to refer patients according to urgency to", "relationship_family": "referral", "display_claim_ids": [ "display-claim:30d129efdc1de85b0689e2f7" ], "display_source_ids": [ "display-source:MLI:7cef05edfa5f331ed8afc820" ], "source_version_ids": [ "display-source-version:3a0f0e27d981923b8c1bc695" ], "display_evidence_object_id": "display-claim:30d129efdc1de85b0689e2f7" }, { "source_node_id": "mli:private-providers", "target_node_id": "mli:regional-hospitals", "relationship": "is stated to refer urgent patients to higher-level hospitals including", "relationship_family": "referral", "display_claim_ids": [ "display-claim:f372d769635f677c71134d7d" ], "display_source_ids": [ "display-source:MLI:7cef05edfa5f331ed8afc820" ], "source_version_ids": [ "display-source-version:3a0f0e27d981923b8c1bc695" ], "display_evidence_object_id": "display-claim:f372d769635f677c71134d7d" } ] }, "title": "Private-provider referral is stated without a volume measure", "statement": "The Ministry strategy states that private facilities refer to CSRef or higher-level hospitals according to urgency. No completion or utilization rate is supplied.", "citation": "Ministère de la Santé et du Développement Social, PS-SNISS 2026-2030, p. 12.", "url": "https://www.sante.gov.ml/article-download.php?article=206&slot=1", "locator": "PS-SNISS 2026-2030, p. 12, section 4.2.2.1.", "period": "Current system description published 2026", "territory": "Mali", "evidence_mode_candidate": "formal", "verification_source_layer": "official", "coverage_domains": [ "ownership", "market_structure", "hospital_organization", "referral_design", "observed_referral", "patient_flows" ], "source_version": { "file_sha256": "638df966261c7b168aa6aa64d33a26c6ce6b34cf4b12ced1ef6f16663391a89f", "hash_verified": true }, "boundaries": [ "Do not infer referral agreements, payment relationships, utilization shares or actual emergency transfer practice from this stated pathway." ], "source_references": [ { "title": "Plan stratégique du système national d'information sanitaire et social 2026-2030", "citation": "Ministère de la Santé et du Développement Social, Mali. 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Mali Accelerating Progress Towards Universal Health Coverage Project ICR. 2025.", "url": "https://documents1.worldbank.org/curated/en/099022025110028997/pdf/BOSIB-ec653f3c-9f8d-4765-825b-f00fbd012a14.pdf", "locator": { "locator_type": "pdf_page_anchor", "physical_pdf_page": 11, "sections": [ "Project background and theory of change, paragraphs 6-7" ], "source_word_anchor": "empowers health facilities with autonomy in budget management", "source_word_count": 8 }, "source_version": { "file_sha256": "b7ffe9db9974ecb6857670fb2e4e242c01e729f619cdad8e2d256078064c621b", "hash_verified": true }, "source_projection_id": "country-improvement-source:MLI:uhc-project-icr-2025", "display_source_id": "display-source:MLI:65b83a3a38a5f2ca6c9fd46c", "source_version_id": "display-source-version:e8086ff26cf8631ddd9b229a" }, { "title": "Health Financing System Assessment: Mali", "citation": "World Bank. Health Financing System Assessment: Mali. 2023.", "url": "https://documents1.worldbank.org/curated/en/099121423052019605/pdf/P1728230412efb0d7099550cce6cbeee2a6.pdf", "locator": { "locator_type": "pdf_page_set_anchor", "physical_pdf_pages": [ 10 ], "sections": [ "Executive summary" ], "source_word_anchor": "Actions can be taken to improve the allocation, distribution and use of funds.", "source_word_count": 13 }, "source_version": { "file_sha256": "5dc9f0eeefcf59f507a40ed9cc68e9be19f607ebeea4301ca3bf8cae313d230c", "hash_verified": true }, "source_projection_id": "country-improvement-source:MLI:hfsa-2023", "display_source_id": "display-source:MLI:284367a4f7255d3c2d7469b9", "source_version_id": "display-source-version:54f3d0d003cd14fe201db3df" }, { "title": "Implementing performance-based financing in peripheral health centres in Mali: what can we learn from it?", "citation": "Coulibaly et al. Health Research Policy and Systems. 2020;18:54.", "url": "https://www.ebi.ac.uk/europepmc/webservices/rest/PMC7268714/fullTextXML", "locator": { "locator_type": "article_section_anchor", "sections": [ "Results", "Implementation process" ], "source_word_anchor": "Referral of patients to services that meet their needs is a new initiative in many centres.", "source_word_count": 16 }, "source_version": { "response_sha256": "2ecab2af78bce9dd8658bbe72f1fb31e2885bd2f82b20f07c41a6e31072ee376", "hash_verified": true }, "source_projection_id": "country-improvement-source:MLI:koul-pbf-implementation-study-2020", "display_source_id": "display-source:MLI:028179ddcf9f506a948069f6", "source_version_id": "display-source-version:94c3cae8d63d8a94e666b7f4" } ], "typed_fields": { "delivery_arrangement": "The PBF project used performance-linked facility resources and reported-data verification; a Koulikoro pilot study reports a strengthened referral-to-needed-services initiative.", "financing_context": "The HFSA identifies primary-care financing and resource allocation as national policy concerns.", "boundary": "Neither source establishes a national facility payment schedule or referral-performance result." }, "analytical_objects": { "provider_delivery_observations": [ { "label": "PBF project delivery arrangement", "observation": "Participating facilities received performance-linked resources and used facility and community or patient verification.", "scope": "Targeted project areas, scaled from Koulikoro to four regions.", "display_claim_ids": [ "display-claim:8130d437537921ff3749b1ae" ], "display_source_ids": [ "display-source:MLI:65b83a3a38a5f2ca6c9fd46c", "display-source:MLI:284367a4f7255d3c2d7469b9", "display-source:MLI:028179ddcf9f506a948069f6" ], "source_version_ids": [ "display-source-version:e8086ff26cf8631ddd9b229a", "display-source-version:54f3d0d003cd14fe201db3df", "display-source-version:94c3cae8d63d8a94e666b7f4" ], "display_evidence_object_id": "display-claim:8130d437537921ff3749b1ae" } ] }, "title": "PBF delivery evidence is targeted, not national", "statement": "The PBF project combined performance-linked facility resources with verification arrangements in targeted regions. A qualitative Koulikoro pilot study reports a strengthened referral-to-needed-services initiative; the HFSA supplies wider financing context, not confirmation of universal implementation.", "citation": "World Bank, Mali UHC Project ICR, 2025, pp. 3-4; Coulibaly et al., 2020, Results; World Bank HFSA: Mali, 2023, pp. viii-1.", "url": "https://documents1.worldbank.org/curated/en/099022025110028997/pdf/BOSIB-ec653f3c-9f8d-4765-825b-f00fbd012a14.pdf", "locator": "ICR PDF p. 11, Project background and theory of change, ‘empowers health facilities with autonomy in budget management’; Coulibaly et al., Results: Implementation process, ‘Referral of patients to services that meet their needs is a new initiative in many centres.’; HFSA PDF p. 10, Executive summary, ‘Actions can be taken to improve the allocation, distribution and use of funds.’", "period": "PBF pilot implemented 2016-2017 and reported 2020; ICR published 2025; HFSA published 2023", "territory": "Koulikoro PBF pilot, targeted PBF project areas, and national health-financing assessment", "evidence_mode_candidate": "observed", "verification_source_layer": "grey_literature", "coverage_domains": [ "autonomy", "primary_care", "facility_data", "utilization", "governance", "authoritative_review" ], "source_version": { "file_sha256": "b7ffe9db9974ecb6857670fb2e4e242c01e729f619cdad8e2d256078064c621b", "hash_verified": true }, "boundaries": [ "Do not infer national coverage, facility performance, financing adequacy or a causal utilization effect from this mixed project and assessment evidence." ], "display_source_ids": [ "display-source:MLI:65b83a3a38a5f2ca6c9fd46c", "display-source:MLI:284367a4f7255d3c2d7469b9", "display-source:MLI:028179ddcf9f506a948069f6" ], "source_version_ids": [ "display-source-version:e8086ff26cf8631ddd9b229a", "display-source-version:54f3d0d003cd14fe201db3df", "display-source-version:94c3cae8d63d8a94e666b7f4" ], "display_claim_ids": [ "display-claim:7a0e141607e0df4028584089", "display-claim:8130d437537921ff3749b1ae" ], "display_evidence_object_id": "display-claim:7a0e141607e0df4028584089", "display_eligible": true, "canonical_claim": false, "publication_boundary": "source_linked_typed_mapping_visible_for_annotation_not_a_canonical_claim" }, { "mapping_id": "candidate-mapping:MLI:relationships-networks:bankass-community-primary-care-network", "country_id": "MLI", "mapping_group": "relationships_and_networks", "target_view": "delivery", "target_slot": "observed-bankass-community-primary-care-arrangement", "support_state": "candidate_supported", "annotation_state": "open", "mapping_basis": "Bankass-district realist process evaluation", "source_projection_ids": [ "country-improvement-source:MLI:proccm-process-evaluation-2024" ], "typed_fields": { "setting": "Eight contiguous rural catchments were each served by a public-sector PHC managed by elected ASACO.", "community_link": "The intervention used professional CHWs and a referral arrangement to link care levels.", "boundary": "This is a study-setting network, not a national network registry." }, "analytical_objects": { "graph_edges": [ { "source_node_id": "mli:community-health-associations", "target_node_id": "mli:community-health-centres", "relationship": "managed study-area primary health centres", "relationship_family": "operations", "display_claim_ids": [ "display-claim:108e7baa4a091daa4b2782f6" ], "display_source_ids": [ "display-source:MLI:84c8b7e4627768f545793c51" ], "source_version_ids": [ "display-source-version:d8b02458720797169532e62a" ], "display_evidence_object_id": "display-claim:108e7baa4a091daa4b2782f6" }, { "source_node_id": "mli:community-health-centres", "target_node_id": "mli:reference-health-centres", "relationship": "was linked through the study referral arrangement toward", "relationship_family": "referral", "display_claim_ids": [ "display-claim:1d7ab7129d841fe36a4e0c4f" ], "display_source_ids": [ "display-source:MLI:84c8b7e4627768f545793c51" ], "source_version_ids": [ "display-source-version:d8b02458720797169532e62a" ], "display_evidence_object_id": "display-claim:1d7ab7129d841fe36a4e0c4f" } ], "provider_delivery_observations": [ { "label": "Bankass study catchments", "observation": "Eight rural catchments each had a public-sector primary health centre managed by elected ASACO.", "scope": "Study setting of approximately 100,000 people, not a national inventory.", "display_claim_ids": [ "display-claim:5b8218091ae2c8458535c318" ], "display_source_ids": [ "display-source:MLI:84c8b7e4627768f545793c51" ], "source_version_ids": [ "display-source-version:d8b02458720797169532e62a" ], "display_evidence_object_id": "display-claim:5b8218091ae2c8458535c318" } ] }, "title": "A community-primary-care arrangement is observed in one district study", "statement": "The Bankass process evaluation describes an ASACO-managed primary-care setting and intervention referral arrangement. The evidence is local and study-specific.", "citation": "Guindo et al. Community case management to accelerate access to healthcare in Mali. 2024, Methods: Study setting.", "url": "https://www.ebi.ac.uk/europepmc/webservices/rest/PMC11384120/fullTextXML", "locator": "Article sections Introduction, Methods: Study setting, and Intervention components.", "period": "Three-year trial and process evaluation reported in 2024", "territory": "Eight rural catchments in Bankass district, central Mali", "evidence_mode_candidate": "observed", "verification_source_layer": "research_literature", "coverage_domains": [ "actors", "primary_care", "referral_design", "networks", "observed_referral", "patient_flows", "utilization" ], "source_version": { "response_sha256": "8ee6fb89ec06f195cd6c43b6aaad9b934d4e1dd42980c0755ace46eaaf98bad3", "hash_verified": true }, "boundaries": [ "Do not generalize this intervention network to all districts or turn the description into a referral-completion measure." ], "source_references": [ { "title": "Community case management to accelerate access to healthcare in Mali: a realist process evaluation", "citation": "Guindo L, et al. Community case management to accelerate access to healthcare in Mali: a realist process evaluation nested within a cluster randomized trial. Health Policy and Planning. 2024. https://www.ebi.ac.uk/europepmc/webservices/rest/PMC11384120/fullTextXML", "url": "https://www.ebi.ac.uk/europepmc/webservices/rest/PMC11384120/fullTextXML", "locator": { "locator_type": "article_section_anchor", "sections": [ "Introduction", "Methods: Study setting", "Intervention components" ], "source_word_anchor": "each serviced by a public sector PHC", "source_word_count": 7 }, "source_version": { "response_sha256": "8ee6fb89ec06f195cd6c43b6aaad9b934d4e1dd42980c0755ace46eaaf98bad3", "detected_media_type": "application/xml", "hash_verified": true }, "source_projection_id": "country-improvement-source:MLI:proccm-process-evaluation-2024", "display_source_id": "display-source:MLI:84c8b7e4627768f545793c51", "source_version_id": "display-source-version:d8b02458720797169532e62a" } ], "display_source_ids": [ "display-source:MLI:84c8b7e4627768f545793c51" ], "source_version_ids": [ "display-source-version:d8b02458720797169532e62a" ], "display_claim_ids": [ "display-claim:aafe039e0a196745d357e0a1", "display-claim:108e7baa4a091daa4b2782f6", "display-claim:1d7ab7129d841fe36a4e0c4f", "display-claim:5b8218091ae2c8458535c318" ], "display_evidence_object_id": "display-claim:aafe039e0a196745d357e0a1", "display_eligible": true, "canonical_claim": false, "publication_boundary": "source_linked_typed_mapping_visible_for_annotation_not_a_canonical_claim" }, { "mapping_id": "candidate-mapping:MLI:relationships-networks:public-community-private-provider-architecture", "country_id": "MLI", "mapping_group": "relationships_and_networks", "target_view": "public-private", "target_slot": "provider-categories-and-community-managed-primary-care", "support_state": "candidate_supported", "annotation_state": "open", "mapping_basis": "current PS-SNISS facility categories and historical private-sector assessment", "source_projection_ids": [ "country-improvement-source:MLI:ps-sniss-2026-2030", "country-improvement-source:MLI:private-sector-assessment-2011" ], "typed_fields": { "public": "The current source lists public CSRef district hospitals, regional hospitals and national hospitals.", "community": "It identifies ASACO-linked CSCom as the base of the pyramid; the 2011 assessment describes them as private not-for-profit community associations.", "private": "The current source distinguishes private for-profit and not-for-profit facilities and parapublic providers.", "boundary": "Categories do not establish market shares, ownership of every facility or common management." }, "analytical_objects": { "graph_edges": [ { "source_node_id": "mli:community-health-associations", "target_node_id": "mli:community-health-centres", "relationship": "is identified as the community association linked to", "relationship_family": "ownership", "display_claim_ids": [ "display-claim:6357a320ab118e6e3143a0d2" ], "display_source_ids": [ "display-source:MLI:7cef05edfa5f331ed8afc820", "display-source:MLI:86a47f6f4d9cd99b6df597b2" ], "source_version_ids": [ "display-source-version:3a0f0e27d981923b8c1bc695", "display-source-version:67a2ccf3a79d402f4b11545c" ], "display_evidence_object_id": "display-claim:6357a320ab118e6e3143a0d2" } ], "provider_organizations": [ { "label": "Community health centres (CSCom)", "ownership": "ASACO-linked community, not-for-profit category in cited sources", "scope": "National system description in 2024; historical assessment interpretation from 2011", "display_claim_ids": [ "display-claim:54840aa4fa4b493a04ce774c" ], "display_source_ids": [ "display-source:MLI:7cef05edfa5f331ed8afc820", "display-source:MLI:86a47f6f4d9cd99b6df597b2" ], "source_version_ids": [ "display-source-version:3a0f0e27d981923b8c1bc695", "display-source-version:67a2ccf3a79d402f4b11545c" ], "display_evidence_object_id": "display-claim:54840aa4fa4b493a04ce774c" }, { "label": "Private providers", "ownership": "For-profit and not-for-profit categories distinguished", "scope": "National system description; not an ownership register", "display_claim_ids": [ "display-claim:f7489039f6609d671b78f228" ], "display_source_ids": [ "display-source:MLI:7cef05edfa5f331ed8afc820", "display-source:MLI:86a47f6f4d9cd99b6df597b2" ], "source_version_ids": [ "display-source-version:3a0f0e27d981923b8c1bc695", "display-source-version:67a2ccf3a79d402f4b11545c" ], "display_evidence_object_id": "display-claim:f7489039f6609d671b78f228" } ] }, "title": "Provider categories do not collapse into one ownership model", "statement": "Mali's current strategy distinguishes public, private, community and parapublic provider categories. 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