Mali is a landlocked West African nation that is primarily agricultural. Work is seasonal – often leaving large portions of the population unemployed. Most Malians live in rural settings where access to health care is limited and infectious diseases such as malaria are rampant.
PSI/Mali was founded in 2001 to use commercial marketing strategies to improve reproductive health and child survival, and to reduce new HIV infections. In 2004, PSI/Mali added malaria programs to its portfolio. In 2007, PSI/Mali introduced programs to reduce the incidence of female genital cutting (FGC), and in 2014, a program on hygiene and sanitation. PSI/Mali is one of the largest PSI network members in West and Central Africa.
PSI/Mali estimates that in 2015, its products and services helped avert 3,887,366 DALYs, including, by health area:
- 3,637,783 Malaria DALYs
- 63,697 HIV DALYs
- 169,349 FP DALYs
- 16,145 MNCH DALYs
- 324 WASH DALYs
- 10 Safe Abortion DALYs
- 59 NCD DALYs
PSI/Mali’s family planning programs also provided 253,324 couple-years of protection.
Malaria
In 2007, PSI/Mali helped distribute more than 2.4 million free long-lasting insecticide-treated nets (LLINs) to children under five. In early 2008, it also began to distribute free LLINs to children under one and to pregnant women nationwide. As of June 2011, PSI/Mali had distributed more than 2 million LLINs that year to pregnant women and children: 1.44 million in eight districts of the Sikasso Region and another 600,000 in four districts of the Segou Region. In 2016, PSI/Mali continued to increase use of LLINs among Malians, especially by children under five and by pregnant women. PSI/Mali is also working to increase the efficiency of diagnostics and malaria treatment products at the community level.
PSI/Mali also works on increasing access to and demand for malaria treatment products and seasonal preemptive treatment products to further decrease the malaria burden.
Contraception
At 9.9%, Mali is among the countries with the lowest modern contraceptive prevalence rates in the world. Despite efforts made in reproductive health, 26% of married women face unmet needs.
PSI/Mali has worked with the Government of Mali to increase the contraceptive prevalence rate, in line with 2015 Millennium Development Goals. As part of this, PSI/Mali is working with the Malian government to operationalize strategies to deliver safe abortion services, post-abortion care, harm reduction counseling, and intrauterine device (IUD) and implant services in a sustainable and scalable way.
It is in this vein that PSI/Mali promotes long-lasting methods via:
- Information: PSI/Mali launched a mass media campaign via radio and television throughout the country to inform the population on the correlation between increased birth spacing and decreased maternal mortality in addition to other benefits resulting from increased birth spacing.
- Advocacy: PSI/Mali has also engaged in advocacy as a means to gain support from national and international decision-makers as well as from religious leaders who have a strong influence on decisions made within the Malian household.
- Community mobilization: Community mobilization plays a large role in all of PSI/Mali’s interventions
- Hotline: PSI/Mali created a telephone hotline where clients can receive all types of information regarding reproductive health, family planning and various contraceptive methods. The hotline directs clients toward PROFAM clinics for further support, care, and information.
- Improved IUD insertion and removal services: PSI/Mali has improved these services via the PROFAM social franchising model in the public and private sector, which both sensitizes and informs the clientele on different contraceptive methods and supports providers in providing quality services.
Child Health
Since 2009, PSI/Mali has been working to reduce mortality and morbidity from diarrheal diseases among children under five. Work has included community presentations of dedicated water treatment products and the importance of its continued usage. PSI/Mali distributes Aquatab tablets nationwide via private sector distribution channels. Activities are complemented by mass media campaigns that promote the effectiveness of point of use water treatment, hand-washing and household water treatment and storage to protect against diarrheal disease.
In another effort to prevent disease and improve water sanitation, PSI/Mali has worked to expand the market for latrines in the country. This project included training masons to construct latrines and handwashing stations, training health promoters to promote latrines, among other efforts.
Neglected Tropical Diseases (NTD)
In 2016, PSI/Mali was designated an Agence d’exécution communautaire (Community Action Agency) by the Organization for the Development of the Senegal River (OMVS) under their Integrated Water Resources Management and Multiple Use Development Project – Phase 2 (PGIRE II). The project works in the Senegal River basin to control malaria, and the five non-tropical diseases (NTDs): schistosomiasis, geo-helminthiasis, lymphatic filariasis, Onchocerciasis and Trachoma. The National Directorate of Health and the National Program to Fight Malaria are also partners on the project.
The strategies under this project include:
- Strengthening collaboration with the OMVS and the Ministry of Health and Public Hygiene, through the coordination bodies.
- Consolidation of strong and lasting partnerships with regional and local authorities, technical and financial partners and local civil society organizations such as community health associations and community education institutions.
- Conducting a study of local knowledge, attitudes, and practices to guide communication strategies.
- Implementation of communication activities for behavior change with a focus on the community component and mass distribution of drugs for the control of NTDs.
- Creation and dissemination of communication materials in local languages.
- Informative broadcasts through community radios, private and national TV channels.
- Mass distribution of long-lasting insecticide treated nets (LLINs) to improve the rate of mosquito net use.
- Awareness activities on early and appropriate treatment of confirmed cases, and malaria prevention.
- Broadcasts on the use and conservation of LLINs.
Donors
- The Federal Government of Germany through KfW Entwicklungsbank (Development Bank)
- The Government of Canada
- United Nations Population Fund (UNFPA)
- Ministry of Foreign Affairs of the Netherlands
- The World Bank
- U.S. Agency for International Development (USAID)
- United Nations Children’s Fund (UNICEF)
- Organization for the Development of the Senegal River (OMVS)
Partners
- Ministry of Public Health of the Republic of Mali
- Ministry for the Promotion of Women, Children and the Family of the Republic of Mali
- Ministry of Energy and Water of the Republic of Mali
- Local and international NGOs including PATH
- Ecole des Maris: Stratégie impliquant les hommes dans la Santé de la Reproduction au Mali
- Evaluation de l’approche « Grin » sur la qualité des Services de Santé Adaptés aux Jeunes (SSAJ) au Mali
Globalement, les obstacles à la planification familliale (PF) pour les jeunes comprennent les barrières socio culturelles, les préjugés des prestataires, le manque de confidentialité, les options de PF limitées, les obstacles financiers et les normes de genre. Les cliniques privées et les pharmacies peuvent jouer un rôle essentiel pour répondre aux besoins des jeunes, car les études précédentes montrent qu'elles peuvent être perçues comme offrant des services de meilleure qualité et une plus grande confidentialité. Le rôle du secteur privé pour répondre aux besoins des jeunes n’est pas suffisamment exploité. - Measuring Equity: Implementers’ Approach to Assessing How Well Social Franchising Reaches the Poor
- Helping Postpartum Women in Mali Achieve their Fertility Intentions: Perspectives from the Dedicated PPIUD Inserter Pilot Program
Mali has one of the world’s highest fertility rates and one of the lowest rates of modern contraceptive prevalence (mCPR). In Mali, more than 1 in 4 women have an unmet need for family planning (FP). This gap between method demand and access is particularly acute for postpartum women, with nearly 70% reporting an unmet need. In 2016, PSI-Mali piloted a new healthcare device to help address this gap- the dedicated postpartum (PP) intrauterine device (IUD) inserter. - Shaping the Family Planning Market by Strengthening the Public Sector
PSI considers total market approaches to be critical for achieving universal health coverage, especially when it comes to contraception. This program brief presents cases, supported by several different donors, which take into consideration the total family planning market. - Developing Family Planning Markets in Francophone West Africa
In Francophone West Africa, PSI partners with Ministries of Health to achieve the goals set out by the Ouagadougou Partnership to reach at least 2.2 million additional family planning users by 2020. The pillars of our response are access, choice, quality, and equity. - Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in Four Countries
In 2013, PSI started a pilot in four countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. Preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. - Reproductive Health Needs of Women Living with HIV in Mali
This presentation focuses on the results of a research study to understand the needs of women living with HIV in Mali. - Applying a Total Market Lens: Increasing IUD Service Delivery in Five PSI Countries
PSI piloted a public sector engagement strategy alongside existing private sector approaches in four countries with low IUD use and found that untapped demand can be met, in part, through greater participation of the public sector. - Le «Grin», Une Approache De Mobilisation Des Jeune Pour L’Adoption De La Pf Au Mali
The Malian population is young, with 65% under 25 years. Similarly, 60% had their first pregnancy by 19 years. 15% of maternal deaths occur in adolescents. According to the 2012 DHS, unmet need for FP is high among young unmarried women. In Mali, the objective of FP 2020 is to increase the rate of modern contraceptive prevalence from 10% to 15% between 2012 and 2018. PSI/Mali in collaboration with the Health Division of the Ministry of Reproductive Health tested a model of youth-friendly services. A Grin is usually a group of young friends having a place to chat and share common values together. This is a widespread practice in Mali.