Favoriser l'accès à l'éducation thérapeutique et réduire les inégalités : analyse d'interventions menées en Afrique et dans l'Océan Indien

The objectives of this article is to point out the potential strengths and obstacles for therapeutic patient education (TPE) as experienced in the implementation and/or development of such actions or programs in Africa (Burundi, Botswana, Mali) and in the Indian Ocean (Mauritius, Reunion, Mayotte). An approach using a «reversed» model, taking advantage of multi-professionalism for the design and framing of TPE programs but also for the downstream use of expert health professionals, appears essential for the access to the greatest number of patients. Feasibility of programs needs strong structuring of actions, adaptation to cultural and linguistic contexts, working with local institutions, professionals and existing field structures, and integration of local and national policies to the organization of care. Whenever possible, coupling epidemiological research and/or qualitative field studies, provides valuable elements for the further understanding and extrapolation of actions and impact.