Passage of Sweeping Health Reforms Promises to Improve Health for Millions of Rural Malians
On February 25, the President of Mali, Ibrahim Boubacar Keïta, announced a series of ground-breaking reforms aimed at reviving Mali’s health system and bringing high-quality healthcare to people across the country. The sweeping reforms include:
- Providing select services free of charge—family planning, emergency primary healthcare, preventative and curative healthcare for children under five, and care for pregnant women
- Increasing the nation’s health budget
- Establishing a rural network of community health workers (CHWs) within the national healthcare system
The latter is particularly vital, as creating a rural network of CHWs will increase access to healthcare among some of Mali’s most hard-to-reach communities. Since 2016, the Health Policy Plus (HP+) project in Mali, funded by the U.S. Agency for International Development (USAID), has been working to advance these policy wins.
Why CHWs Matter
Difficulty accessing health services—whether due to distance, wait times, availability of health workers and commodities, cost, or other obstacles—leaves 400 million people around the world without essential healthcare services. Workforce shortages are one of the biggest factors restricting access to health services, particularly in rural areas. Globally, there is an estimated shortage of 17.4 million healthcare workers needed to achieve universal health coverage. CHWs—who provide basic healthcare at the community and household levels—offer a cost-effective way to help fill this gap. In Mali alone, these workers were responsible for liaising with three million Malians in 2015—40 percent of the country’s rural population—and CHWs have played a vital role in the country’s anti-malaria campaign.
Policy for Progress
HP+ Mali has worked with local partners to advance policies aimed at expanding access to services by making better use of CHWs. The project has conducted analyses, including estimating the costs of using CHWs to deliver essential services and the gap in financing these workers, and developed a tool to map the distribution of CHWs. The project’s tool and analyses were used to inform advocacy efforts conducted alongside community health program stakeholders. HP+ is also helping to facilitate partnerships between private sector companies and local communities to explore how companies can further support CHWs. The project is continuing to work alongside civil society partners and the Association of Malian Municipalities to engage local mayors. In 2018, after a series of meetings with local officials in several regions, 150 mayors committed to including a line item for CHWs in their local budgets. Seydou Traore, HP+ Mali Country Director commented, “HP+, through advocacy, supports integration of CHWs into the formal health system, as they can significantly reduce the mortality of women and children—given the crucial role CHWs play in communities through providing timely access to life-saving care.”
Sustaining the Momentum
While Mali’s new health reforms don’t take full effect until 2022, they have the potential to greatly impact the lives of Malians and set a precedent for the formal integration of CHWs into health systems and support of healthcare reform worldwide. Until then, HP+ will continue to work alongside local partners to ramp up support for these reforms and ensure their ongoing sustainability.