By Oren Jusu, Director Emergency Preparedness and Response and Nesrine Talbi, Consultant Emergency Preparedness and Response
Mali grapples with numerous health disparities, exacerbated by factors such as poverty, conflict, political instability and climate crisis. UNOCHA estimates that 7.1 million people in Mali need humanitarian assistance including 23 percent of women and 54 percent of children. These challenges directly impact sexual and reproductive health and family planning outcomes, deriving in high maternal mortality rates, unintended pregnancies, limited access to contraceptives, increased risks of gender-based violence and amplified gender disparities in healthcare access and decision making.
The need for contraceptives does not stop during emergencies but rather increases. Voluntary family planning is a human right and has been proven to save lives and improve women’s health. It plays a significant role in preventing unintended pregnancies, reducing maternal and infant mortality, and controlling the spread of sexually transmitted infections. Moreover, in displacement settings, access to contraception and reproductive health services and information provide women and girls control over their bodies and futures, subsequently impacting their social and psychological well-being. Despite this evidence, it is found that availability of family planning and other sexual and reproductive health services continue to fall through the cracks during emergencies.
Family planning and sexual and reproductive health Emergency Preparedness is vital
Given the volatile world we live in, the risks of climate change, conflicts and health pandemics, preparedness is not optional, it is vital – and particularly for countries like Mali that rate as “very high risk” on the INFORM Risk Index. Preparedness provides government and humanitarian actors with a framework to systematically analyze and monitor risks, take early actions, and flag capacity gaps at all levels to mobilize timely and adequate support in response to emergencies.
To better respond to the complex realities women and girls live in, FP2030 has centered its investment in emergency preparedness and response, considering it as a key strategy to save lives during stressors and shocks to healthcare systems or societies at large. Through its Emergency Preparedness and Response Center of excellence, FP2030 is uniquely positioned to broker tailored support to commitment-making countries through its national focal points and technical working groups through the Ministry of Health and create cross-country and cross-regional learning opportunities.
Mali recognizes the need for family planning and sexual and reproductive health Emergency Preparedness and Response
When the FP2030 team visited key partners in Bamako during April 2024, the temperature was at 42 °C, a stark reminder that in addition to conflict and insecurity, climate change adds on an additional layer of vulnerability to the already protracted humanitarian situation the country is facing.
Recognizing these challenges, Mali made an FP2030 commitment in 2021 with a clear vision: “A Mali where the Family Planning needs of women, adolescents and young people, including vulnerable groups, are taken care of with access to information and affordable, quality services of full range of modern contraceptive methods, with respect for human rights and accountability to women and adolescent”. As part of its commitment, Mali has clearly prioritized EPR by including several objectives and strategies to ensure continuity of SRH care during emergencies, access to contraceptives during crisis and budget allocation for SRH in emergencies.
The effects of crisis and hazard severely disrupt SRH/FP services when ill prepared, hence exacerbating existing vulnerabilities and placing lives at risk. In Mali, several gaps have been identified including the fragility of healthcare infrastructures, the lack of trained healthcare providers in hard-to-reach areas, inadequate coordination mechanisms that bridge the divide between development and humanitarian actors and the lack of integration of family planning and sexual and reproductive health in relevant emergency response policies. The consequences of an inadequate enabling environment can lead to disruption in care and will have a disproportionate impact on women and girls. By investing intentionally in emergency preparedness, risks can be mitigated and contribute to ensuring continuity of SRH/FP information and services during emergencies.
During the FP2030 support visit to Mali, the team met with Dr. Ben Moulay Idriss, Director General of the General Directorate of Reproductive Health who shared that there is a gap in sexual health and family planning services and provision in general and the need to scale up services to remote areas. He mentioned the need to develop a new costed implementation plan as the one developed for 2023 expired in April, and the need for trained health care providers in hard-to-reach communities, but there has been a significant gap in funding.
Recommendations for advancing emergency preparedness and response in Mali
FP2030 together with national stakeholders laid out key recommendations to bolster emergency measures to safeguard access to family planning and sexual and reproductive health services in Mali and outlined strategies to enhance preparedness and response efforts. FP2030 will work with key stakeholders in Mali through the MoH to ensure that:
- Sexual and reproductive health including family planning are integrated in emergency response plans, policies, and strategies
- Coordination mechanisms are mainstreamed to ensure effective and timely response by providing SRH/FP information and services to adolescent and women affected by the ongoing conflict
- Robust data monitoring and surveillance systems are available to enable early detection of emerging SRH/FP issues during emergencies
- Collection and analysis of data on key indicators such as maternal mortality, contraceptive prevalence, and disease outbreaks, to allow for timely intervention and resource allocation
Sustained international support and commitment to integrating family planning services within broader humanitarian response initiatives are crucial for improving the situation in Mali. Efforts must be concentrated on building resilient health systems that can withstand the impacts of conflict and displacement. Moreover, a continuous dialogue between international health agencies (humanitarian and development) including donors, local governments, and communities is essential to tailor family planning policies and practices to the needs and norms of the Malian population.
Ultimately, investing in family planning and sexual and reproductive health emergency preparedness is not only a matter of public health but also a human rights imperative, empowering individuals to exercise their reproductive rights and lead healthier lives, even in the midst of crises.
