Bulletin of the World Health Organization

Integration of basic dermatological care into primary healthcare services in Mali

Antoine Mahé, Ousmane Faye, Hawa Thiam N’Diaye, Habibatou Diawara Konaré, Ibrahima Coulibaly, Somita Kéita, Abdel Kader Traoré, & Roderick J. Hay



To evaluate, in a developing country, the effect of a short training programme for general health care workers on the management of common skin diseases — a neglected component of primary health care in such regions.


We provided a one-day training programme on the management of the skin diseases to 400 healthcare workers who worked in primary healthcare centres in the Bamako area. We evaluated their knowledge and practice before and after training.


Before training, knowledge about skin diseases often was poor and practice inadequate. We found a marked improvement in both parameters after training. We analyzed the registers of primary healthcare centres and found that the proportion of patients who presented with skin diseases who benefited from a clear diagnosis and appropriate treatment increased from 42% before the training to 81% after; this was associated with a 25% reduction in prescription costs. Improved levels of knowledge and practice persisted for up to 18 months after training.


The training programme markedly improved the basic dermatological abilities of the healthcare workers targeted. Specific training may be a reasonable solution to a neglected component of primary healthcare in many developing countries.