In Mali, Local Leaders Oversee Domestic Funding of Community Health Workers
In Mali, as is the case in many African countries, community health workers (CHWs) provide essential healthcare services—and the need for services provided by this essential workforce is only expected to increase over time. Despite a strong reliance on CHWs, the program is largely donor-dependent, jeopardizing the sustainability of the workforce in the long term.
Between October 2019 and January 2020, local stakeholders—including mayors, community health associations, and communities—mobilized more than 7.8 million FCFA (approximately US$13,305) in local resources to support payment of CHWs in the regions of Kayes and Sikasso following the end of stipend payments from USAID’s High-Impact Health Services Project in September 2019. In February 2020, HP+ Mali, in collaboration with the Association of Malian Municipalities, developed an interview guide for monitoring municipal commitments in favor of CHWs and support given to the Essential Community Care program.
Later in 2020, regional health directorates used these tools during field trips to Kayes and Sikasso to assess management of the funds and become acquainted with locally developed mechanisms that support the CHWs. The assessment revealed that approximately 95 percent of CHWs have remained at their posts following cessation of donor funding and more than 50 percent of these workers are being supported by locally developed mechanisms. Critically, local authorities are transparently managing the community-mobilized funds, ensuring that local contributors are involved in verifying the appropriate allocation to the intended beneficiaries. By taking ownership over these processes, local stakeholders are ensuring that the essential health services provided by CHWs continue to be available to communities, creating an enabling environment for health that is sustainable, transparent, and effective.