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Annex 2.4 Page 5 of *5

construction, upgrading and equipping of health services will be carried out with the aim of bringing them closer to the populations and minimizing the number of cases moved to the hospitals for treatment. To this end, the Ministry of Health will first endeavor to open the nonfunctioning CSPSs.

23.    To enable these districts to become operational, the Ministry has begun to train district supervisory teams with the help of a team of trainers based in the Training Center for Health Development (CFDS). This center will also be given responsibility for overseeing the supervisory teams that are trained. These supervisory teams will train and supenrise the staffs of the outlying health centers. The training of CMA doctors in emergency surgical procedur es is being organized with the assistance of the School of Health Sciences at the University of Ouagadougou. The Ministry will continue to recruit personnel during the coming years. It will also start redeploying and training existing staff to comply with the minimum staffing norms adopted. Moreover, in its continuing effort to rationalize the health sector, the Ministry of Health will carry out a study of the hospital sector, the results of which will be used as inputs in the preparation of the country-wide plan for the redeployment, training and recruitment of health staff.

24.    To ensure broad community participation in the management of health facilities, steps have been taken to give the peripheral health facilities financial autonomy (cf. Decree No. 93-001/PRES/MFPL/SASF/MAT conferring management autonomy on the Stale's peripheral health facilities, and its implementing regulations No. 93-015/SASF/MFP/MAT of February 4, 1993). The management committees will be installed according to a phased Schedule.

25. Development of the hospital centers and peripheral health facilities will cali for the establishment of a maintenance structure to manage the medical equipment and plant. It will comprise a central maintenance service backed up by regional units, all provided with adequate eąuipment and appropriate capabilities.

26. The pharmaceutical policy developed to support the Primary Health Care rehabilitation strategy advocates the promotion of generic essential drugs, which must be madę geographically accessible, as well as affordable, if the ąuality of health care is to be improved. With this in mind, the Procurement Center for Generic Essential Drugs (CAMEG) was created in May 1992, with the task of bringing good-quality, affordable drugs within reach of the population. Accordingly, the CAMEG's goal is to supply all health facilities with essential drugs at an affordable price. This measure will be accompanied by action to promote a morę circumspect approach to prescription writing and by the quality control of imported generic drugs.

27. With respect to the fight against transmissible diseases, the implementation of a variety of programs has enabled the spread of certain endemic diseases in the country to be completely or partially controlled. The task for the coming years will be to consolidate the efforts madę in this field and to optimize the results through improved coordination of activities. As malaria is the chief cause of morbidity and mortality in Burkina Faso, chemotherapy for patients with fever will be continued, together with research on anti-vector control and the resistance of Plasmodium to chloroquine. Financing of the expanded devolution program comprising the control of onchocerciasis, dracunculiasis and trypanosomiasis will be continued in an effort to find effective Controls for these endemic diseases.