Mali can be a challenging environment for health care, especially for women. Maternal, neonatal and infant mortality rates all remain high, as does the fertility rate, while the use of modern contraception remains relatively low. To complicate matters, regions like Timbuktu lack sufficient numbers of health providers, and those that do exist often lack the capacity to guarantee high-quality care and services.
Moreover, women are underrepresented in positions of responsibility within the health centers. In the Timbuktu health district, for example, only 20 percent of the technical directors are women. Since taking on leadership duties, however, Souma has demonstrated impressive success. Her facility has an excellent reputation due to its technical capacity and the organizational practices she has helped put in place. She serves as a role model among her peers in the district.
Souma also enjoys her interactions with clients. As an active member of the local women’s association, she enlivens discussions on health topics during meetings so that women want to attend and learn more about maternal, child and general health services. “In the center, we do awareness sessions for behavior change in hygiene, vaccination, infant and young child feeding [and] on family planning. The process is slow, but … women are increasingly beginning to attend care services for themselves and their children. I am proud to observe this.”
Women are at the heart of MOMENTUM Integrated Health Resilience not only because of its focus on mothers, newborns and children, but also because its activities are based on the needs expressed by the participants themselves. Once they identify their community priorities for maternal, newborn and child health, as well as for family planning, their input is used to inform the project’s annual work plan and the implementation of activities. Community participation is integral to every phase of the project, and this synergistic approach has proven effective and is highly valued at both the local and national levels.
By partnering with communities, MOMENTUM is already succeeding in Mali. The project involves the entire community in implementing complementary health activities. Teams engage community health associations and community health workers as well as nutrition support groups and crisis and disaster management committees. Wide-ranging activities include strengthening the capacity of the associations to practice good governance, training government officials in relevant technical areas to enhance their performance and responsiveness, and mobilizing communities to strengthen their agility and health resilience.
The results are encouraging. As Souma points out, “I am already seeing an increase in attendance at the health center, and I link it to the advocacy supported by the project. Trust is built, and the cash flow can support the expenses of the health center. This was not the case before.”