Empowering midwives in Mali to transform women’s health

Bamako — Kadidia, 19, once feared judgment when discussing contraception. “I was ashamed to talk about it because it’s still a taboo in our community,” she admits. Like many young women in Mali, Kadidia faced social, cultural, and structural barriers to accessing sexual and reproductive health services. In 2024, Mali recorded 583 maternal deaths, including 89 among adolescents aged 15 to 19. While progress has been made—with 559,493 young women and girls accessing modern contraception in 2024 compared to 480,682 in 2023—challenges remain. Of Mali’s 4.8 million women of reproductive age, many still lack critical health resources.

Why sexual and reproductive health services matter for young women

Access to tailored reproductive health services is essential for safeguarding the future of young women. These services empower them to make informed decisions about their bodies, reduce unintended pregnancies, prevent sexually transmitted infections (STIs), and enhance both physical and mental well-being. Yet, persistent taboos and systemic gaps continue to hinder progress, making equitable access a public health priority.

The World Health Organization (WHO), with support from a major donor, is collaborating with Mali’s government to implement a comprehensive program addressing these gaps. The initiative focuses on strengthening legal frameworks, enhancing healthcare provider skills, supplying medical equipment, establishing youth-friendly clinics, and generating reliable data to guide policy decisions.

Legal reforms and healthcare system enhancements

Key achievements include training judges on WHO guidelines, launching a national health observatory, and reinforcing maternal death surveillance systems. 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 uphold health rights, particularly for youth and adolescents.”

The WHO’s role extends beyond technical support, acting as a catalyst for coordination and supervision. Thanks to this collaboration, Mali now publishes its first national bulletin on sexual and reproductive health indicators and the 2022 National Health Accounts—tools that provide deeper insights into performance and guide strategic decisions.

Bringing services closer to vulnerable communities

Initiatives like the Mother-Child-Adolescent clinic in Sikasso and mobile health teams in Macina are bridging gaps for underserved populations. Dr. Sylla Ousmane, WHO’s Sexual and Reproductive Health Program Manager in Mali, shares, “These efforts aim to make essential services more accessible to those who need them most.”

The pivotal role of trained midwives

Midwives are at the heart of this transformation. Continuous training has significantly improved the quality of care for young women. Aïssata, a midwife at a community health center in Kebila, says, “I’ve been trained in prenatal care, family planning, STI/HIV management, and medical prescriptions. This has enhanced my ability to serve young women without judgment.”

Assetou, a mentor midwife in Yanfolila, echoes this sentiment: “The training changed how I approach my work—fostering listening, availability, and respect for consent.” Between 2019 and 2025, her center saw a more than twofold increase in adolescents accessing sexual and reproductive health services, from 2,330 to 5,121.

Breaking taboos and fostering trust

Awareness campaigns in schools, radio programs on sexuality, and provider training in active listening have encouraged young women to seek care. Kadidia reflects on her first visit to a health center: “The staff listened without judgment and gave me valuable advice. These services truly contribute to our well-being. I urge other young women not to be afraid—help is available.”

Through these efforts, Mali is not only improving health outcomes but also reshaping societal attitudes, one empowered young woman at a time.