UNICEF USA: Maternal and Child Health in Mali
In Mali, Hawa Diawara, 18, interacts with her 24-day-old baby boy, Youssouf Sanogo, at home in Koumatou. “I was so happy when Youssouf arrived – he is my first baby,” Hawa said. “The whole family was happy for me. Everything went well: I arrived at the health centre four days before giving birth – I had felt a dull pain in my abdomen, but then the actual delivery went fast. The midwife walked with me to the pregnancy room. She supported me, encouraged me – it decreased the pain and accelerated the birth. After the birth, they used water to wash me; my sweat and blood was washed off [with water from the well]. I felt clean afterward[s], and my family came to celebrate.” In Mali, the neonatal mortality rate is 31 per 1,000 live births (2016, IGME data). Sikasso region has a neonatal mortality rate of 35 per 1,000 live births – slightly above the national average. Most newborns die from perinatal asphyxia, neonatal infections or prematurity. These deaths are largely preventable.
UNICEF became active in Mali in 1986, but still faces steep challenges – specifically, the ratio of qualified health personnel per inhabitant is too low. In Koumantou, for example, there is only one doctor, trained by UNICEF, to serve the entire population. One midwife, one nurse, three health workers and two vaccination agents assist him. In addition, Mali has one of the world’s highest child marriage rates. Around one in seven girls marries before the age of 15, and 71 per cent by 18. Also, 91 per cent of women aged 15–49 is circumcised, increasing the risk of deadly infections – most of them before the girls reach the age of 5. Child mothers’ babies are more vulnerable: If a mother is under 18, her baby is more than twice as likely to die than an infant born to an adult mother (older than 19). But thanks to UNICEF interventions, most recently, many lives have been saved – in Koumantou and Bougouni, neonatal mortality numbers have gone down.