How trained midwives are transforming maternal health in Mali

Bamako — Kadidia, a 19-year-old student in Bamako, shares her story: “I used to feel ashamed to even mention contraception. In my community, it’s still a taboo topic. I feared judgment and gossip.” Her experience reflects a broader challenge across Mali, where young women face significant social, cultural, and structural barriers when accessing sexual and reproductive health services.

Maternal health challenges in Mali

Despite progress, Mali continues to grapple with high maternal mortality rates. In 2024, the country recorded 583 maternal deaths, with 89 occurring among adolescents aged 15 to 19. Early and unintended pregnancies remain a major public health concern. While the situation has improved—with 559,493 young women and adolescents accessing modern contraception in 2024 compared to 480,682 in 2023—there is still much work to be done. In 2024, Mali had nearly 4.8 million women of reproductive age, highlighting the urgent need for accessible healthcare solutions.

Improving access to sexual and reproductive health services is critical for young women’s safety and future. These services empower them to make informed decisions about their bodies, reduce unintended pregnancies, prevent sexually transmitted infections (STIs), and enhance their overall physical and mental well-being. In a society where stigma persists and risks are high, ensuring these rights is a top public health priority.

WHO’s role in strengthening reproductive health in Mali

The World Health Organization (WHO), in collaboration with major donors, is supporting Mali’s government in implementing an ambitious program to advance sexual and reproductive health rights. The initiative focuses on:

• Strengthening legal frameworks to protect reproductive health rights.
• Enhancing healthcare providers’ skills through continuous training.
• Providing essential medical equipment to healthcare facilities.
• Establishing youth-friendly clinics tailored to the needs of adolescents.
• Generating reliable data to guide public health policies.

Dr. N’Tji Keita, Head of the Maternal and Child Health Department at Mali’s National Office of Reproductive Health, explains: “This program is embedded in our strategic plan to safeguard healthcare rights, especially for young people and adolescents. We’ve trained judges on new WHO guidelines, launched a national health observatory, and strengthened the maternal death surveillance system.”

The WHO’s support extends beyond technical assistance. It plays a pivotal role in coordinating and supervising activities, enabling Mali to publish its first national bulletin on sexual and reproductive health indicators and the 2022 National Health Accounts. These tools provide deeper insights into performance and inform strategic decisions.

Expanding access to vulnerable communities

Initiatives such as the Mother-Child-Adolescent Clinic in Sikasso—which offers integrated family planning and gender-based violence support—and mobile health teams serving humanitarian zones like Macina are bringing essential services closer to underserved populations.

The impact of trained midwives on young women’s health

Midwives are at the heart of Mali’s reproductive health transformation. Their continuous training has significantly improved the quality of care for young women. Aïssata, a midwife at the Kebila Community Health Center, shares: “I’ve received advanced training in prenatal care, family planning, STI/HIV/AIDS management, and medical prescriptions. This has not only enhanced my skills but also allowed me to welcome young women without judgment.”

Assetou, a mentoring midwife in Yanfolila (160 km south of Bamako), echoes this sentiment: “These training sessions have revolutionized my approach. I now prioritize listening, availability, and respecting consent.” Between 2019 and 2025, the number of adolescents and young people accessing sexual and reproductive health services at her center more than doubled, rising from 2,330 to 5,121.

Beyond statistics, these improvements are evident in changing attitudes and behaviors. Sensitization campaigns in schools, radio programs on sexuality, and provider training on active listening and consent have encouraged young women to seek care. Dialogues are opening, stigmas are fading, and trust is growing.

For Kadidia, the impact is tangible. “The healthcare worker who attended to me made me feel comfortable. She listened without judgment and gave me excellent advice. I can confidently say these services contribute to our well-being. To other young women, I say: don’t be afraid. Seek advice—we’re here to help you.”