empowering malian youth: how trained midwives are transforming sexual health

Bamako – “I was ashamed to discuss contraception because it remains a sensitive topic in some communities here. I didn’t want to be judged or become the subject of neighborhood gossip,” recounts Kadidia, a 19-year-old student in Bamako.

Kadidia’s experience mirrors that of thousands of young women in Mali who encounter significant social, cultural, and structural obstacles when trying to access sexual and reproductive health services. In 2024, Mali recorded 583 maternal deaths, with 89 occurring among adolescents aged 15 to 19. The risks associated with early and unintended pregnancies continue to be substantial. While these figures indicate progress, they also underscore the considerable work that still needs to be done: in 2024, the nation had nearly 4.8 million women of childbearing age, and 559,493 young women and adolescents successfully accessed modern contraceptive methods, a notable increase from 480,682 in 2023. 

Providing young women with appropriate and accessible reproductive health services is a crucial factor for their safety and future well-being. By enabling them to make informed decisions about their bodies and health, these services play a vital role in reducing unintended pregnancies through contraception, preventing sexually transmitted infections, and enhancing their overall physical and mental health. In a context where deep-seated taboos persist and risks are high, guaranteeing these fundamental rights emerges as a critical public health priority.

Addressing this pressing reality, the World Health Organization (WHO), with support from a major donor, is actively assisting the Malian government in implementing a comprehensive program designed to advance rights and access to sexual and reproductive healthcare. The Organization’s support encompasses strengthening the legal framework, enhancing the capabilities of healthcare providers, supplying essential medical equipment, establishing youth-friendly clinics, and generating reliable data to inform public health policies. 

“This program is integral to our strategic plan and aims to safeguard healthcare rights, particularly for young people and adolescents. We have successfully trained magistrates on new WHO guidelines, established a national health observatory, and reinforced the maternal death surveillance system,” explains Dr. N’Tji Keita, Head of the Mother and Child Health Department at the National Office for Reproductive Health.

WHO’s involvement extends beyond technical assistance; it serves as a vital catalyst in coordinating and overseeing these activities. Thanks to its sustained support, Mali now possesses its inaugural national bulletin on sexual and reproductive health indicators, alongside the 2022 National Health Accounts. These essential tools facilitate a more thorough analysis of performance and guide strategic decision-making.

“We have supported the establishment of a Mother-Child-Adolescent clinic in Sikasso, which will offer integrated family planning services and care for gender-based violence. A mobile team is also prepared to operate in the humanitarian zone of Macina. These initiatives are designed to bring services closer to the most vulnerable populations,” clarifies Dr. Sylla Ousmane, who leads the Sexual and Reproductive Health Program at the WHO office in Mali.

Trained and committed midwives are at the very heart of the system that is profoundly transforming the health outcomes for young girls. Their ongoing professional development has led to a significant improvement in the quality of care provided to this demographic. Aïssata, a midwife at the Kebila community health center, shares her experience. “I received extensive training on focused prenatal consultations, family planning, management of STIs/HIV/AIDS, and medical prescription. This has greatly enhanced my practice and enabled me to welcome young women without judgment,” she states proudly.

Assetou, a mentor midwife in Yanfolila, approximately 160 kilometers south of Bamako, corroborates this: “These training sessions brought about a profound change in my approach to work, particularly regarding attentive listening, availability, and respecting consent.” From 2019 to 2025, the number of young people and adolescents benefiting from sexual and reproductive health services at her center more than doubled, increasing from 2,330 to 5,121. 

These improvements are not solely measured in statistics but are also evident in evolving attitudes and behaviors. Through awareness campaigns in schools, radio broadcasts addressing sexuality, and training healthcare providers in empathetic listening and consent, young girls are now more confident in seeking care at health centers. Dialogue is opening up, taboos are gradually receding, and trust is steadily building. 

For Kadidia, this transformation is deeply felt. She recalls her first visit to the health center: “The woman who attended to me made me feel at ease; she listened without judgment and gave me excellent advice. I can truly say that this service contributes to our well-being. I want to tell other young girls: don’t be afraid, go seek advice, they are there to help us,” she concludes with conviction.