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L'architecture d'entreprise « une seule santé » du Burkina Faso
Abstract
Suite à l'avènement de menaces sanitaires graves impliquant des maladies transmises des animaux aux hommes, le gouvernement burkinabè a décidé de prendre au sérieux la menace que représente les maladies zoonotiques, en adoptant l’approche « One-Health » encore appelée « une seule santé » en français. Cette approche promeut une gestion unique et intégrée de la santé animale et humaine afin de fournir une réponse adéquate et compréhensible aux menaces d'épidémies en général et de maladies zoonotiques en particulier. Cependant, pour devenir une réalité, une telle approche nécessite la mise en place d'une plateforme électronique capable de remonter les informations en temps réel et de notifier les acteurs clés de potentielles menaces sanitaires dans le pays, d'où la nécessité d'une infrastructure informatique en adéquation avec les objectifs poursuivis. Le présent document est une tentative de décrire les actions requises pour un alignement parfait entre les objectifs et l'infrastructure technique pour atteindre les résultats escomptés, à travers la mise en lumière des prérequis organisationnels, politiques, informationnels, techniques et infrastructurels nécessaires au succès d'une telle entreprise.
L'objectif principal de ce document est de fournir un outil de politique et de planification aux différents ministères participant à l’approche « une seule santé » au Burkina Faso, leur permettant d'établir et de mettre en œuvre un système d'information commun de surveillance en temps réel des maladies zoonotiques, interopérable entre ministères afin d'offrir au pays une vue globale sur les données collectées afin d'optimiser la riposte. Plus particulièrement, ce document établit une analyse comparée des architectures d'entreprise des systèmes d'information sanitaire des Ministères de la Santé, de l'Environnement et des Ressources Animales et Halieutiques du Burkina Faso, afin de leur garantir un alignement parfait entre la vision de l'approche « une seule santé », leur politique de gouvernance, leur flux d'information, les applications informatiques mises en place et l'infrastructure informatique qui les supporte.
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Le renforcement du système d’information sanitaire (SIS) dans les pays en développement est de plus en plus basé sur des outils sophistiqués et des logiciels nécessitant une infrastructure en technologies de l’information et de la communication (TIC) adéquate permettant la capture facile, le transfert, le stockage, le traitement et l’analyse des données tout en pouvant aussi soutenir une large diffusion de l’information produite pour éclairer le processus de prise de décisions.
Le choix du Burkina Faso pour l’instauration d’une plateforme électronique de gestion des données de la surveillance selon l’approche « Santé Unique » a nécessité un audit de l’état des infrastructures TIC existantes au sein des trois ministères concernés par cette approche : le Ministère de la santé, le Ministère de l’environnement, de l’économie verte et du changement climatique et le Ministère des ressources animales et halieutiques
L’outil d’évaluation des infrastructures TIC, développé par MEASURE Evaluation, a permis d’évaluer les capacités des différents niveaux du système de santé afin de fournir une indication sur l’état actuel de son infrastructure TIC ainsi que sur les actions nécessaires pour son amélioration selon les objectifs à atteindre.
Une auto-évaluation mixte avec des méthodes qualitatives et quantitatives a permis de collecter les données auprès du personnel de gestion des données de chaque structure de la pyramide sanitaire. Elle a aussi pu déterminer les bases de développement d’une architecture intégrée du SIS qui permettraient une interopérabilité entre les sous-systèmes d’une approche « Santé Unique » au Burkina Faso et de formuler des recommandations pour une mise à niveau de l’infrastructure soutenant le SIS du Burkina Faso.
Brucellosis is a highly contagious zoonosis caused by bacteria of the genus Brucella and affecting domestic and wild mammals. In this paper, the bacteriological and serological evidence of brucellosis in Sub-Saharan Africa (SSA) and its epidemiological characteristics are discussed. The tools available for the diagnosis and treatment of human brucellosis and for the diagnosis and control of animal brucellosis and their applicability in the context of SSA are presented and gaps identified. These gaps concern mostly the need for simpler and more affordable antimicrobial treatments against human brucellosis, the development of a B. melitensis vaccine that could circumvent the drawbacks of the currently available Rev 1 vaccine, and the investigation of serological diagnostic tests for camel brucellosis and wildlife. Strategies for the implementation of animal vaccination are also discussed.
Developing countries and the global network of donors, programs and nongovernmental organizations (NGOs) have agreed that health systems need to become stronger if gains in health are to be achieved and sustained. Existing data collection and use is fragmented, disease specific, inconsistent and often of poor quality. A major factor contributing to this current situation is that the burden of data collection falls to health workers and that this burden is excessive. What is needed is a national health information system that is capable of supporting day-to-day management, long-term planning, and policy development for the entire national health system. Front line health workers who bear the burden of data collection should benefit from the availability of information for decision making in a well designed health information system. A health information system is comprised of multiple and diverse functions and applying what has been learned from other sectors is valuable. One such practice developed over the past 20 years to guide planning, development and management of complex systems in all sectors including, government, commercial, and NGOs is the development of enterprise architecture. The enterprise architecture is the next level of elaboration of the HMN Framework where general lessons, standards, and processes can be aggregated and documented for knowledge sharing. A well thought-out and collaboratively supported architecture enables systems to be built and implemented using consistent standards for data collection, management, reporting and use. The components of the enterprise architecture will be adapted from or collaboratively generated with the global disease programs whose buy in and endorsement is crucial to its success. Investments in health information systems can be aligned and leveraged around such an architecture to build stronger core health information systems supporting better local health services management, health policy and ultimately stronger health systems.
Genetic analysis of highly pathogenic avian influenza (H5N1) viruses from poultry and hooded vultures in Burkina Faso shows that these viruses belong to 1 of 3 sublineages initially found in Nigeria and later in other African countries. Hooded vultures could potentially be vectors or sentinels of influenza subtype H5N1, as are cats and swans elsewhere.
In this paper, the authors put forward an intermediary model that can support the transition between a business model and an IT infrastructure, then provide an example of how the approach can be used. The model is based on a combination of existing models: enterprise architecture and the Business Model Canvas. The authors show how the proposed intermediary model, which has a strong focus on a business model strategy, can help IT alignment. The intermediary model can help alignment from either a business model focus or an IT infrastructure focus because of the correspondence between the two paradigms. The focus on visualization within the intermediary model aids in quickly illustrating the common ground held by the parties involved in the alignment.
A study of the prevalence of bovine tuberculosis and brucellosis was conducted in dairy cattle farms in and around the city of Ouagadougou, Burkina Faso. It reveals the potential economic and health impact of these two major zoonoses in the study area. Three farming systems were included in the study. A total of 1,420 cattle were tested for tuberculosis and 1,689 cattle were tested for brucellosis. The intradermal tuberculin test was used for tuberculosis, and the buffered antigen test and indirect enzyme-linked immunosorbent assay were used for brucellosis. The overall prevalence rate is estimated to be 6.05% for tuberculosis and 3.61% for brucellosis. The prevalence rates of tuberculosis and brucellosis in urban and peri-urban dairy cattle farms in Ouagadougou were found to be high. As these two production-linked diseases are zoonotic, they could pose a major risk to human health and contribute significantly to reducing animal production and productivity in the areas covered by the study. Animals should be checked systematically prior to introducing them into dairy herds, with the ultimate goal of eradicating these two zoonoses.
Genetic characterization of 32 canine rabies viruses circulating in Burkina Faso in 2007 identified two clades both belonging to the Africa 2 lineage. Sequence homology data suggest that transboundary spread is the most likely means of introduction, highlighting an evolving epidemiological situation.
Zoonotic diseases constitute a public health problem throughout the world, particularly in the tropics, where their control is restricted by inadequate infrastructure and financial resources. Additionally, there is a lack of information on their significance and distribution. This study, conducted jointly by the Ministries of Health and Animal Resources, aimed to assess the prevalence of zoonotic diseases in Burkina Faso. The data were taken from internal reports of each ministry covering the period January 1-December 31 1996 for the Ministry of Health and for January 1-December 31 1997 for the Ministry of Animal Resources. Zoonotic diseases were divided into viral (rabies, yellow fever, HIV infection/AIDS, and measles), bacterial (tuberculosis, brucellosis, and anthrax) and parasitic (cysticercosis, toxoplasmosis, and leishmaniasis). For the period under study, the following diseases were reported by the Ministry of Health, tuberculosis, 1314 cases; anthrax, 145 cases; leishmania, 271 cases; rabies, 110 cases; and measles, 46490 cases. The Ministry of Animal Resources reported 69% of rabies cases occurred in dogs; cysticercosis occurred in swine at a prevalence of 0.57%; the prevalence of tuberculosis in cattle, small ruminants and pigs was 0. 13, 0.013, and 0.029%, respectively; the prevalence of anthrax and echinococcosis was 0.012 and 0.007%, respectively; and finally, the prevalence of bovine brucellosis was 8% in the peri-urban areas. This study revealed that there was a lack of collaboration between the organisational structures and workers in both ministries involved in the control of zoonoses. Links between the two ministries in the field of public health need strengthening.
Ebola: Mapping the Outbreak
Graphique 16: Architecture des applications « comme-à-être »................................................................................ 40
RÉFÉRENCES
1. BBC News. Ebola: Mapping the Outbreak. January 14, 2016. Disponible à:
https://www.bbc.com/news/world-africa-28755033
Rapport sur l'état des lieux de la cartographie des applications de remontée et d'analyse au Ministère de la Santé
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