High-quality health services and trained health workers have been crucial to Mali’s progress over the past decade in addressing obstetric fistula, a devastating, disabling childbirth injury that can result from prolonged labor. Obstetric fistula affects more than 2 million women in Asia and sub-Saharan Africa. Every year in Mali, up to 2,400 women and girls are at risk of developing it.

10 Years of Obstetric Fistula Care in Mali offers insights on sustainability in fistula care, mobilizing communities, and key suggestions for neighboring West African countries that face similar challenges.

The Fistula Mali project provided obstetric fistula repair surgeries for 1,214 women.

It also highlights five key interventions that have driven Mali’s progress in fistula care, including:

• Decentralizing fistula surgery. Training local surgeons throughout the country to perform fistula repair surgeries has not only expanded fistula care, but also enabled more hospitals to offer routine surgeries for the first time.
• Optimizing performance and quality at fistula treatment sites. A signature approach to problem-solving has improved the working environment for health workers at fistula treatment sites and the quality of care women and their families receive there.
• Strengthening national NGOs’ fistula care capacities. Outreach and community health workers from local NGOs have been essential to Mali’s progress, making care available to remote villages and the women most in need.
• Strengthening public-private partnership. By partnering with a local telecommunications company and others, Mali has built welcome centers at fistula treatment sites and vastly improved the health care experience for clients and their families.
• Operational research. The results of operational research projects like those conducted by the IntraHealth-led Fistula Mali project encourage policy-makers and technical and financial partners in the country to make decisions based on data and evidence.

The Fistula Mali project, which was funded by the US Agency for International Development, drove and contributed to many of the successes highlighted in the report. During 2014–2018, the project and its partners accomplished these results and more:

• provided obstetric fistula repair surgeries for 1,214 women
  • 75% of those women had fully closed fistulas after surgery
  • 68% had completely closed and dry fistulas after surgery
• trained 520 health workers to provide fistula care services
  • 25 were surgeons, and 11 of those can now perform all obstetric fistula surgeries without supervision
• trained 1,628 health workers in family planning and reproductive health
• trained 1,067 community health workers and community relays on fistula prevention and screening
• recruited 1,938 women with suspected cases of fistula recruited for care
• conducted 6,017 educational talks with religious and community leaders, women’s groups, youth groups, and others on the factors that contribute to fistula and ways to prevent it, on ending social discrimination, and on the availability of treatment services in health facilities
• produced 36,747 radio broadcasts in local languages
• held 36 training campaigns for treatment and surgical teams
• achieved 81.3% accuracy rate (1,160/1,426)—compared to less than 50% previously—in screenings carried out by community NGOs supported by the project

Read the report now: 10 Years of Obstetric Fistula Care in Mali: A Case Study of Multisectoral, Holistic Treatment for Women and Girls

The Fistula Mali project was funded by the US Agency for International Development. Learn more about IntraHealth’s work in Mali to improve health and well-being for families.