Improving Health Care in Mali

The health system in Mali is not sufficiently equipped to deal with Covid-19 patients. Poor eduction and a lack of resources are the main problems. The Netherlands works together with the Global Financing Facility, the World Bank and the Malinese government to tackle the challenges.

2 women with baby and 2 children on iron bed
©Curt Carnemark

Covid-19 affects us all. The Sahel region in Africa is no exception, and it also faces additional challenges. The health system in Mali, for example, is ill-equipped to deal with Covid-19 patients. Other health services, such as pregnancy care, risk falling short under the additional pressures. An adequate response to the virus is of worldwide importance. The Netherlands is therefore investing in the improvement of Mali’s health system, now more urgently needed than ever.

The Ebola crisis that took hold of West Africa in 2014 taught us that an additional burden on the health system significantly increases women’s risk of dying in childbirth. Moreover, many people will avoid seeking healthcare of any kind during such a crisis for fear of infection.

Women and girls

The Netherlands works together with the Global Financing Facility, the World Bank and the Malinese government to improve health care in Mali. Local health centres are crucial to combat corona, but they are also extremely important for the longer term. The Dutch contribution focuses on the prevention of harmful practices that affect women and girls, such as early marriage and early pregnancy. These lead to an increased risk of birth complications, fistulas and low birth weight. The programme improves both access to and use of high-quality health services.

Portrait of man in white coat
Dr Moussa Bagayoko is a health worker in the Koulikoro region of Mali

Dr Moussa Bagayoko about the current healthcare situation in Mali

What is the biggest challenge in Mali in terms of healthcare?

'One of the biggest challenges in Mali is posed by the poor distribution of financial, material and human resources. To improve this in the long term, a local approach is essential. People working in remote healthcare facilities need to have access to the right equipment, medicine and infrastructure. Such distribution systems work most efficiently when set up by local people who know the local context best.'

How is Covid-19 affecting the Malian healthcare system?

'Covid-19 is a big public health problem in my country. The healthcare system is not sufficiently prepared to respond to such an emergency.

First, we are dealing with a population that is poorly educated. This leaves people very susceptible to false information that is circulating on social networks. Many have lost confidence in the health system and healthcare workers.

Second, the decision-makers have failed to allocate sufficient resources to health centres and the epidemiological surveillance system. Health centres are poorly equipped for treating the sick. Only four laboratories are accredited for coronavirus testing, and all of these are located in Bamako.

Finally, the health workers responsible for coordinating the epidemiological surveillance and care system are often unmotivated. They lack the resources they need to do their work, often due to inefficient administrative procedures.'

'The Project to Accelerate Progress Towards Universal Health Coverage (PACSU) will be implemented by the World Bank and the Ministry of Health in Mali, in collaboration with the Dutch Embassy and the Global Financing Facility. This project will tackle these major challenges that the Malinese health system is facing. One of the characteristic innovations of the PACSU project is the Result Based Finance (RBF). It implies that health services provided, are paid for based on results, after checking their effectiveness and quality. This  improves the quality of health services and enables improved access to them. It does so both at the community and district level, benefitting the poorest households. In these times of crisis, this has become ever so important.'