Celebrating Collaborative Success in Strengthening Health Systems and Services Despite Challenges: Seven Years of HP+ in Mali
Words from beneficiaries, partners, stakeholders, and supporters shaped a meeting Thursday in Bamako, Mali, that marked the end of seven years of work carried out by the Health Policy Plus (HP+) project, funded by the U.S. Agency for International Development (USAID). About 120 people attended in person to hear remarks from the U.S. Embassy, the USAID Mission, the government of Mali, , and the HP+ country director—plus video testimonials from HP+’s global project director, government and civil society stakeholders, and religious leaders, as well as samples of HP+ publications detailing the project’s work in Mali.
HP+ has worked closely with partners across Mali’s health system, with a particular focus on health financing over the last two years of the project. Representatives of Mali’s National Health Insurance Fund and Devolution and Decentralization Support Team (CADD) emphasized the importance of the in-depth health financing analyses HP+ has conducted to support Mali’s efforts to strengthen the health system. These analyses have focused on provider payment systems, public financial flows for health, health system efficiency and equity at all levels, and more, and were completed in close collaboration with these key partners.
“There is much to celebrate as we mark the conclusion of HP+ Mali,” said Suneeta Sharma, global project director. “From our work with community health workers to advocate for the formalization of their status by law, to our partnership with religious leaders in combating gender-based violence, we have seen remarkable results. Impressively, this work has moved forward, even during the past two years as the HP+ Mali team adapted to the global COVID-19 pandemic.”
Julia Henn, director of health at USAID/Mali, commemorated the collaboration between the governments of Mali and the United States to drive progress toward a stronger health system in a period marked by political change and a global pandemic. In closing her remarks at the ceremony, she emphasized, “Although HP+ is coming to a close, we are still with you and will continue to support the Malian population.”
The project’s work in Mali has aimed to improve access for Malians to reproductive, maternal, and child health services—remaining committed to increasing equity and improving data demand and use that underpin strong health systems. HP+ focused on an evidence-to-action approach, and strengthened the capacity of partners in Mali to carry this approach forward. A notable example is HP+’s data-based advocacy work in favor of community health workers’ (CHWs) rights and legal status, carried out over the past seven years. After conducting a situational analysis on CHWs in 2015, HP+ began supporting advocacy and resource mobilization efforts using data from a robust visual data-mapping platform co-created with government stakeholders. These efforts led to the recent adoption of a decree enshrining the formal status and rights of CHWs, which marked a transformative step toward making essential community healthcare sustainable and accessible for all Malians.
Boubacar Traoré, technical director of the Association of Malian Municipalities, took up the theme of community health worker advocacy in his video remarks: “Regarding community health workers, one could say that the importance of this work was really to give confidence to [them]… all the way from the awareness-raising work to the signature of the contracts between community health workers and local authorities.”
On the same topic, Baboua Traoré of the Malian government’s Devolution and Decentralization Support Team emphasized the importance of the adoption of the decree on community health workers for actors across the health system, such as traditional midwives. “It’s a win-win partnership,” he said of HP+ and his team’s work to support CHWs.
Imam Mamadou Traoré, a member of the office of the High Islamic Council of Mali, congratulated HP+ on its collaborative work to engage Muslim and Christian leaders to engage in topics such as gender-based violence, the COVID-19 response, and reducing stigma for people living with HIV. After raising awareness of these subjects with a selected group of religious leaders, he said, “[we asked] about 250 Imams and pastors to return to their holy texts to pull out testimonies so that we could set in place talking points… Then we went out into five regions of Mali to raise awareness among other Imams and pastors… The first two days [of our awareness-raising events] there were about 50 people, then it grew to 100. They really liked the talking points and started to write sermons on these themes. So it has had a large effect.” The pastors and Imams didn’t stop there, but went on to amplify HP+ messages about COVID-19 and vaccine awareness because, as he said, “Certain [messages], if they come from religious leaders, people do not hesitate [to follow].”
Mali’s director general of health and public hygiene, Dr. Cheick Amadou Tidiane Traoré, applauded HP+’s work in strengthening health systems. “HP+ supported the department [of health and public hygiene] by seconding technical assistants to certain sub-directorates, notably to strengthen capacity but also to strengthen the institutions, allowing the teams to be more operational and better manage their responsibilities.”
HP+ Mali’s closing project event was an opportunity to focus on collaboration, innovation, and resilience in the face of difficult circumstances. Stakeholders across Mali’s health system intend to build on the strong foundation HP+ has helped build and to continue making progress toward an equitable health system for all Malians.