Strategizing for Fistula Prevention and Treatment in Mali

For many women in Mali, becoming pregnant is a major health risk. The lifetime risk for maternity-related death is one in 22 (UNICEF 2010). According to the United Nations Children’s Fund, fewer than half of women in Mali give birth with the help of a skilled attendant.

The Malian Ministry of Health (Minisante) continues to demonstrate its commitment to preventing and treating obstetric fistula, a devastating health condition caused by obstructed labor. The Minisante, with support from the Fistula Care project, held a workshop March 22–24, 2011, in Selingue, Mali, to update its national policies, norms, and procedures (PNP) on fistula and to develop tools and job aids to support fistula services. Meeting participants reviewed and adapted available tools and standards on fistula treatment, prevention services, and training for use in Mali.

The meeting’s 24 participants are key stakeholders in preventing or treating fistula, including fistula surgeons, heads of the regional divisions for health and hospitals providing fistula services, and officers of local, national, and international organizations and agencies. The participants work in four of Mali’s regions: Gao, Mopti, Segou, and the District of Bamako. The participants addressed a diverse group of topics, including repair training, prevention, integration with family planning, and counseling.

The workshop participants adapted several tools from the Fistula Care project, including a site assessment tool, booklets and forms about informed consent and family planning, and other tools on diagnosis and counseling. The participants also selected indicators from the Fistula Care quarterly report to track the progress of fistula prevention and treatment.

The updated PNP, tools and job aids are expected to be disseminated nationally in August 2011, followed by regional dissemination later in the year. The meeting was cofacilitated by the Minisante and Fistula Care partner IntraHealth International, with technical assistance provided by EngenderHealth’s Senior Program Associate Mieko McKay and Senior Medical Associate Dr. Isaac Achwal. Fistula Care will continue to provide support to the Minisante to ensure that these tools and job aids are rolled out and used to improve fistula service delivery in Mali.


UNICEF. 2010. Mali Statistics. Retrieved from:, June 20, 2011.