Mali: In Mali, Women Are Driving Health Care Forward

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Delivering lifesaving health services in Mali requires resilience and determination. Even amid security challenges, extreme weather and inequality, women continue to demand - and deliver - the care that keeps them, their families and their communities healthy.

For decades, the Global Fund and its partners in Mali, including the Ministry of Health and civil society organizations, have stood alongside the most vulnerable communities, investing to defeat the world's deadliest diseases while strengthening health systems that reach women and children wherever they are.

Here, we meet the health workers, and the women and families they serve, whose determination is delivering real progress despite immense challenges.

The Centre de Santé Communautaire (CSCOM) Sébéninkoro, in Bamako, Mali. Women in Mali face some of the highest maternal health risks in the world: They are nearly twice as likely to die from pregnancy or childbirth complications compared to the global average. These risks extend to their children, who are nearly three times more likely to die before reaching their fifth birthday than children globally. Expanding access to quality maternal, newborn and child health services is essential to saving lives and supporting women's health and resilience.

Across Mali, community health centers - known locally as centres de santé communautaire (CSCOMs) - are a core pillar of primary care and expand access to lifesaving services. Run by local communities and supported by the Ministry of Health, these centers provide integrated, patient-centered services, including antenatal check-ups, skilled childbirth support, malaria prevention, HIV treatment and postnatal care.

Global Fund investments help strengthen these frontline health centers by equipping them with reliable medicines, essential diagnostics and well-trained health workers. Community health workers are able to extend care beyond the walls of the health centers - reaching people in their communities and homes - so that lifesaving services are accessible to everyone who needs them, especially in underserved and remote areas.

Astan Diabate consults with midwives Keita Aissata and Auissallee Maija at the CSCOM Sébéninkoro, in Bamako, Mali. Astan Diabate, who is 18 weeks pregnant with her sixth child, consults with midwife Keita Aissata at the Sébéninkoro CSCOM in Bamako - every year, more than 700 babies are born at this health center. In a region where many pregnant women remain exposed to malaria, integrating malaria prevention services into antenatal care is critical to protecting women's health and ensuring safer pregnancies.

Astan receives a mosquito net and sulfadoxine-pyrimethamine, a preventive medicine to protect herself and her unborn baby from malaria.

"The care is very good here," says Astan. "This is why I have come here for all six of my children."

Between 2022 and 2024, investments from the Global Fund supported malaria programs across Mali that reached millions of families. A total of 16.5 million mosquito nets were distributed, achieving nearly 100% household coverage.

Over the same period, nearly 1.4 million expectant mothers received preventive malaria treatment, and each year approximately 3 million children under 5 were reached with seasonal malaria chemoprevention - preventative medicines provided during the peak malaria transmission season - covering up to 95% of eligible children across the entire country.

Community health worker Mariata Bengaly, who works at the Sébéninkoro CSCOM, conducts a home visit. Mariata Bengaly, a community health worker affiliated with the Sébéninkoro CSCOM, visits a woman at her home who is pregnant and living with HIV. In Mali, where nearly half of all pregnant women living with HIV lack access to the treatment that can prevent mother-to-child transmission of the disease, the home-based care that Mariata provides is a lifeline.

During this visit, Mariata delivers antiretroviral treatment, monitors her patient's viral load with dried blood spot tests and provides antenatal care. In circumstances like these - when women cannot reach a health facility - Mariata brings care directly to them, ensuring they receive the essential care that they need.

Globally, nearly two-thirds of maternal deaths happen in conflict-affected or fragile countries, where the risk of dying in pregnancy or childbirth is about five times higher.

The Sénou internally displaced person (IDP) camp shelters approximately 1,200 people living in crowded and difficult conditions with limited access to basic services. Women and girls face enormous challenges in accessing health care.

In response, the Global Fund and partners are bringing lifesaving services directly to women and girls staying in Sénou - through mobile clinics, maternal and newborn health programs and outreach initiatives that connect women to care.

Women attend a maternal and neonatal health education session led by Dr. Djeneba Sow at the Sénou IDP camp. Dr. Djeneba Sow, from Synergie Action Santé, a Global Fund partner, leads maternal and neonatal health education sessions for women at the Sénou IDP camp.

Her sessions provide guidance on antenatal care, safe delivery practices, malaria prevention, HIV testing and treatment, breastfeeding and postnatal care, and other health concerns.

By equipping women with knowledge, and connecting them to essential services, Dr. Sow helps keep women and children healthy.

Mariam and her 2-year-old son Boubacar at the Sénou IDP camp. Mariam and 2-year-old Boubacar - her youngest child - have been living in the Sénou IDP camp for six years, having fled insecurity and violence in Mali's center region. She is a mother of six: Her first four children were born without antenatal care or trained medical support. In Sénou, she was connected to care during her last two pregnancies.

"During my first four deliveries, I was in and out of consciousness. With the last two, I stayed fully aware," she says. "Life is not easy here as a woman," Mariam adds, "but people are helping me."

Investments from the Global Fund have helped connect women in Sénou to health services, improving access to maternal care for displaced families.

CESAC - the Centre for Listening, Care, Activities and Advice - was Mali's first dedicated HIV clinic, founded in 1996.

Supported by the Global Fund and run by long-standing partner ARCAD Santé PLUS, CESAC provides a range of health services, including HIV prevention, treatment and care, and programs specifically for children, adolescent girls, and women.

Today, CESAC is a model of dignity-driven, patient-centered care.

Lountani Sissoko with children at the pediatric division of CESAC. On the bottom-right, she is pictured with the head of pediatrics, Dr. Savadogo Mahimadouk (far right) and pediatrician Dr. Karudjatou Diakite (middle). Lountani Sissoko leads psychosocial support programs for children living with HIV at CESAC. She helps children understand their diagnosis, adhere to their treatment, and build self-esteem in a safe space.

Since 2008, CESAC has supported children living with HIV.

Today, 456 children receive lifesaving treatment at the clinic, returning every three months for medication and ongoing psychosocial support. From around age 7, children are taught - using age-appropriate language - what HIV is and why daily treatment matters.

"There was a time when children were ashamed to come here, but not anymore. In addition to medical care, we must focus on building their confidence and self-esteem," says Lountani.

Yama Kanoute with her son Mohammed at CESAC. For 13 years, Yama Kanoute has accessed lifesaving HIV care at CESAC. Diagnosed while pregnant, she was immediately connected to treatment - keeping herself and her children healthy. Every three months, Yama travels an hour to CESAC to receive free treatment, viral load testing and medical support. Here she is with her youngest son Mohammed, who is HIV-free.

"The care here is very good, especially the doctors," says Yama.

In Mali, despite the ongoing challenges and hardships facing many women and girls, access to HIV prevention, treatment and care has expanded, including helping women stay healthy during pregnancy and motherhood, and ensuring children are born HIV-free.

The Global Fund has financed 100% of all antiretroviral therapy in Mali for the past two decades. Since 2002, AIDS-related deaths have fallen by 60%, and treatment coverage has risen from 5% in the early 2000s to 68% in 2024.

With this long-standing, transformative investment, women, girls and children across the country can access lifesaving, patient-centered care that keeps them alive and fosters a strong and resilient community.

FootNotes

Written by Melanie Sharpe. Photography by Vincent Becker. With special thanks to ARCAD Santé PLUS and the Ministry of Health.

Read the original article on Global Fund.

Mali: In Mali, Women Are Driving Health Care Forward

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