219. In terms of reference and organization of counter-reference system, in 2010, 100% (59/59) of the referral health centres had a revised conceptual framework or a framework that was under review, at least one surgical unit, trained personnel and appropriate equipment (including rolling stock, computers and RACs). 220. The quality of care is improving year by year at this level of care for patients through multidisciplinary management teams with adequate means of diagnostics and a system of organizing, monitoring and evaluating programmed or non-programmed operations. This reference level refers also to the 14 Hospital Facilities (EHs) including 11 public hospitals (EPHs), commonly referred to as 2nd or 3rd baseline hospitals, more efficient for the treatment of complicated cases or medical specialties, surgery, gynaecology-obstetrics or for conducting complementary para-clinical diagnostic examinations, etc. 221. The reform of the hospital system led to the practice of hospital medicine that guarantees the quality of care, better reception and guidance of patients and the reduction of medical evacuations outside the country (reduction of expenses on families and the State, which continues to provide financial and logistical contribution in this area). 222. The organization and implementation of the legislative and regulatory framework favourable to the development of private medical and pharmaceutical practices led to the provision of a dense network of health practitioners especially in large cities. This led to a positive response to a request for long-awaited individual private care. In 2010, Mali had more than 1412 public, private and community health institutions, 1462 drug deposit or sale facilities, including 497 private facilities and 92 laboratories with only 9 of them being private. 223. These various health institutions contributed in 2010 to the curative care of 0.36 contacts per inhabitant per year. The 11 EPHs helped in the care of 722,396 patients of which only 6.2% of cases were referred, and the hospitalisation of 134,439 patients for an overall occupancy rate of 41% which ranged from 8 to 66% and for an average stay of 4 days, including extreme cases which ranged from 3 to 16 days. 224. In the area of prevention, serious childhood infectious diseases for which children pay the highest price dropped significantly due to immunization of children within the framework of the Expanded Programme on Immunization (EPI), which incorporates routine vaccination, vaccination revival days, searching days or synchronized sub-regional campaigns using the door-to-door approach within the framework of eradicating poliomyelitis and even other diseases where it was feasible. Hence, we note that the vaccination coverage in Penta 3 (5 vaccines) was 104% in 2010 (exceeding the target of at least 90% per year). As a reminder, Mali benefited from the certification of Poliomyelitis after several consecutive years without polio, following the standards set by the WHO (pre-eradication phase). 225. As part of the fight against the disease, several strategies and interventions are underway to forcefully fight back HIV/AIDS, the prevalence rate of which stood at 1.3% according to the EDSM-IV in 2006 as against 1.7% in 2001. 226. Within the purview of this fight, in 2010, Mali had 265 voluntary counselling and screening centres (CCDVs). These centres enabled the screening of 129 039 persons, 3192 of whom were HIV-positive, representing 2.47% as against 25.38% in 2006. Also, in 2010, 35 45