Research Publication

The community health system in Mali: An overview

This brief provides an overview of the community health system in Mali. The system is decentralized and operates across five levels: national, regional, district, health area, and community. It relies on two cadres of community health workers to deliver health-care services, primarily to rural populations: agents de santé communautaire (ASCs) and relais communautaire. The National Implementation Guide for Essential Community Health Care is the main document that outlines responsibilities of community health providers and processes for organization, management, and delivery of health services. Although Mali’s maternal, child (under five years), and infant mortality rates have fallen over the past two decades, they still remain among the highest in the world. To reduce the number of maternal, child, and infant deaths and significantly improve health outcomes for the general population, the government is introducing a series of national health-care reforms, expected to take full effect by 2022. They include: providing contraceptives free of charge; free preventative and curative health care for children under five and pregnant women; increasing national budget allocations to health; adding thousands of ASCs to the health workforce and standardizing their role within the national health system.