Six-Year Collaboration Strengthens Mali’s Health Workforce

At an event in Bamako last month, CapacityPlus and the Ministry of Health and Public Hygiene shared key results of their six-year collaboration to strengthen Mali’s health workforce. Around 100 people attended the event where ministry officials and project staff highlighted the key role of health workers and successful human resources for health (HRH) approaches for building more resilient health systems and reaching more Malians with better quality health care.

“Human resources are the cornerstone upon which the entire health system rests, a system which in fact would not exist without them,” said Dr. Moussa Guindo, the ministry’s head of cabinet, in his remarks. “They are the health system’s most important resource.”
Mali needs more highly skilled and equitably distributed health workers to address current health needs. A woman in Mali has a one in 26 lifetime risk of dying from a maternal cause, and only 10% of women use modern contraceptives.  Malaria and emerging infectious diseases are also major health concerns, particularly in Mali’s remote, rural areas where access to health care is most limited. Mali has only 5.1 physicians, nurses, and midwives per 10,000 people. The World Health Organization recommends a minimum of 23 per 10,000 to provide basic, essential services.
Over the course of the project, Mali’s health system was further threatened by the violent takeover of the country’s northern regions by radical Islamists in 2012 and the ongoing threat of the Ebola outbreak in West Africa. These events have slowed the country’s progress toward its health goals. Health workers have been instrumental in the country’s recovery from the conflict and in stemming the spread of Ebola when Mali confirmed its first isolated cases in 2014.
“The only way to meet the ambitious goals of reducing maternal, neonatal, and infant mortality; reducing the incidence of HIV/AIDS, malaria, and infectious diseases; and preventing the spread of emerging diseases,” said Cheick Touré, IntraHealth International’s country director in Mali, “is to ensure the availability of sufficient numbers of well-trained health workers.”
Over the past six years, CapacityPlus worked with the ministry and local organizations to increase the availability, distribution, and quality of health workers through a comprehensive package of support. Key accomplishments of the project shared at the event include:
·         Provided comprehensive support to the Gao Nursing School located in the northern, remote region of Mali both before and after the rebel occupation. The project worked with school officials to improve the reproductive and family planning curricula and establish a five-year plan to recover from the destruction. The project also provided scholarships to more than 200 nursing and midwifery students over the past two years to help ramp up the number of health workers in the north. Scholarship recipients were significantly more likely to pass the national certification exam (64%) compared to other students (29%).  A June 2015 assessment showed the majority of health workers currently serving in Mali’s northern regions graduated from Gao Nursing School.
·         Strengthened Mali’s systems to collect, update, and use data on its health workforce. The project helped the HRH Directorate introduce and scale up iHRIS Manage—open source software that tracks information about health workers including current post locations, work and salary histories, qualifications, and ongoing training. Mali is already making changes based on these data. Examples include identifying experienced supervisors to lead a new health center in Bamako, tracking health workers who fled the north in 2012 to offer them grants to return, and implementing a rotation system for midwives and recruiting new health workers to address a severe shortage uncovered in Sikasso region. 
·         Facilitated better coordination of HRH stakeholders’ advocacy efforts and activities. The project helped facilitate and strengthen Mali’s HRH Stakeholder Leadership Group. This group influenced and is now tracking the HRH commitments Mali made at the Third Global Forum on Human Resources for Health in Recife, Brazil, in 2013. 

 ·         Developed sexual and gender based violence training materials to help health workers identify, treat, and support victims. Health workers are often a victim’s first point of contact. These documents have helped health workers and local organizations to network and provide more targeted and effective medical and psychosocial support to victims. Mali is planning a national rollout of the training curricula.