Empowering malian midwives to transform women’s health outcomes

Bamako — Kadidia, a 19-year-old student in Bamako, once feared judgment when discussing contraception. « I was ashamed to talk about it because it’s still a taboo topic in some communities, » she recalls. « I didn’t want people in my neighborhood to talk about me. » Like Kadidia, many young women in Mali face deep-rooted social, cultural, and structural barriers to accessing sexual and reproductive health services.

In 2024, Mali recorded 583 maternal deaths, including 89 among girls aged 15 to 19. Early, unintended pregnancies remain a critical health risk. While progress has been made—the country had 4.8 million women of reproductive age in 2024, with 559,493 accessing modern contraception in 2024 compared to 480,682 in 2023—these figures underscore both gains and the urgent need for continued action.

Access to tailored reproductive health services empowers young women to make informed choices about their bodies and futures. These services help reduce unintended pregnancies through contraception, prevent sexually transmitted infections, and improve physical and mental well-being. In a society where taboos persist and risks loom large, ensuring these rights is a public health priority.

WHO’s comprehensive support for sexual and reproductive health in Mali

The World Health Organization (WHO), with support from a major donor, is collaborating with the Malian government to implement an ambitious program aimed at expanding access to sexual and reproductive health services. This initiative focuses on strengthening legal frameworks, enhancing healthcare provider skills, supplying essential medical equipment, and establishing youth-friendly clinics. Additionally, it emphasizes generating reliable data to guide policy decisions.

« This program is embedded in our national strategy to uphold healthcare rights, especially for young people and adolescents, » says Dr. N’Tji Keita, Head of the Maternal and Child Health Department at Mali’s National Office of Reproductive Health. « We’ve trained magistrates on updated WHO guidelines, launched a national health observatory, and strengthened maternal death surveillance systems. »

The WHO’s role extends beyond technical support—it acts as a catalyst for coordination and supervision. Thanks to this partnership, Mali now publishes its first national bulletin on sexual and reproductive health indicators and the National Health Accounts for 2022, providing critical data to inform strategic decisions.

Innovative initiatives to reach vulnerable populations

« We supported the creation of a Mother-Child-Adolescent clinic in Sikasso, offering integrated family planning and gender-based violence services, » explains Dr. Sylla Ousmane, WHO’s Sexual and Reproductive Health Program Manager in Mali. « A mobile team is also ready to serve the humanitarian zone of Macina, bringing services closer to those who need them most. »

The transformative impact of trained midwives

Midwives, the backbone of this initiative, play a pivotal role in improving reproductive health outcomes for young women. Their continuous training has significantly enhanced the quality of care provided.

Aïssata, a midwife at the Kebila community health center, shares: « I’ve received training in focused prenatal care, family planning, STI/HIV/AIDS management, and medical prescriptions. This has boosted my confidence and allowed me to assist young women without judgment. »

Assetou, a mentor midwife in Yanfolila, 160 km south of Bamako, echoes this sentiment: « These trainings have revolutionized my approach to patient care, emphasizing active listening, availability, and respect for consent. » Between 2019 and 2025, the number of adolescents accessing sexual and reproductive health services at her center more than doubled, rising from 2,330 to 5,121.

Breaking taboos and building trust

The shift in attitudes is evident. School awareness campaigns, radio programs on sexual health, and provider training in empathy and consent have encouraged more young women to seek care. Dialogue is opening, taboos are fading, and trust is growing.

For Kadidia, this transformation is tangible. « The staff welcomed me without judgment, listened patiently, and gave me excellent advice, » she says. « I want to tell other young women: don’t be afraid to seek help. These services exist to support us. »