Pélengana is a municipality of Muslim tradition, located about fifteen kilometres from the city of Ségou in Mali. It’s 10 a.m. this January morning, and the freshness of the morning is gradually giving way to the warmth of the sun. At the Community Health Centre in Pélengana Sud, there’s a special feeling in the air. Women sing and dance under a shed in the middle of the centre. They are attending an educational talk on sexual and reproductive health.
Néné Tamboura is a 25-year-old woman and a community development worker. In the middle of the women, she is explaining the advantages of contraceptives in family planning and screening for sexually transmitted infections, or STIs. Mrs. Tamboura is assisted by the neighborhood’s “model husbands” club.
The inhabitants of Pélengana are mostly conservative. Husbands prevent their wives from seeking sexual and reproductive health services because they are unaware of the benefits of these services. Most men in Pélengana believe the myths that circulate about contraception and STI screening; for example, that these services transmit diseases, make women infertile, or encourage young people to engage in prostitution.
In Mali, all Community Health Centres offer sexual and reproductive health services. In addition to these centres, NGOs such as the Malian Association for the Protection and Promotion of the Family, or AMPPF, and Action to Support the Development of Population Activities, or ASDAP, also provide sexual and reproductive health services in Pélengana.
Mariame Thiame is a midwife at the AMPPF mobile clinic. She says that sexual and reproductive health is a state of physical, mental, and social well-being related to all aspects of the reproductive system. Fulfilling this right enables women and men to enjoy a satisfying and safe sex life, which includes deciding whether or not to have children, as well as when and how. Ms. Thiame adds that sexual and reproductive health includes family planning and the fight against STIs and female genital mutilation, as well as consent in sexual relations and childbearing.
Ms. Thiame says that, in order to maintain sexual and reproductive health, one must be able to access accurate information and the safe, effective, affordable, and acceptable method of contraception of one’s choice. She says that everyone should be informed and empowered to protect themselves from STIs. And when they decide to have children, women must be able to access the services that help them to have the best possible pregnancy, give birth safely, and deliver a healthy baby.
Ms. Thiame says that family planning and sexually transmitted infections are the best-known aspects of sexual and reproductive health in Mali. For family planning, several methods are available, divided into short-acting methods, long-acting methods, and permanent methods.
Short-term methods include the pill and the two- to three-month injectable. The long-lasting methods include intrauterine devices (IUDs) and Jadelle, which each last for three to five years. Finally, there are the permanent methods of vasectomy and tubal sterilization. These methods are all available from Community Health Centre’s sexual and reproductive health services in Mali. In addition, Ms. Thiame says that preventing and treating STIs such as HIV, syphilis, or genital herpes are part of sexual and reproductive health. These infections are treated in all Community Health Centres in Mali. She advises people to get tested by a dedicated service to improve their sexual and reproductive health, and protect themselves and their partner.
Despite the availability of these types of services, many sexual and reproductive health services in Mali are under-used.
To raise public awareness of the benefits of sexual and reproductive health and use of sexual and reproductive health services, ASDAP establishes “model husband clubs” in the 19 districts of the city of Ségou. Each club has 15 members and a president.
The Pélengana “model husbands” club is a group of men who, after training sessions on sexual and reproductive health, help raise women’s awareness about using sexual and reproductive health services.
Mamadou Traoré is the president of the Pélengana model husbands club. Before joining the club, he was against women using sexual and reproductive health services. Mr. Traoré explains: “Before, I was told that contraceptives prevent women from becoming pregnant, or make them sick.” But after the training, he discovered the benefits of attending sexual and reproductive health services, and became an ambassador. Now he encourages his wife and others to use sexual and reproductive health services by giving educational talks in the neighborhoods of Pélengana.
Thanks to this awareness campaigns, women and men in the region are increasingly using these services. Salimata Keita is a midwife based at the Community Health Centre in Pélengana. She says that there were more than 600 women in the Community Health Centre of the municipality of Pélengana in 2021 who used the long-term method of contraception and more than 915 who used short-term methods. During this same period, there were 1,745 male condoms distributed and 240 cervical cancer screenings.
She concludes: “With the support of ‘model husbands,’ we are seeing increased attendance at sexual and reproductive health services.”
This resource was produced through the “HÉRÈ – Women’s Well-Being in Mali” initiative, which aims to improve the sexual and reproductive health well-being of women and girls and to strengthen the prevention of and response to gender-based violence in Sikasso, Ségou, Mopti, and the district of Bamako in Mali. The project is implemented by the HÉRÈ – MSI Mali Consortium, in partnership with Farm Radio International (RRI) and Women in Law and Development in Africa (WiLDAF) with funding from Global Affairs Canada.
Photo: Foune Kouyate waits to vaccinate her baby, Kadidia Goulibaly, at the Centre De Sante Communautaire De Banconi (ASACOBA) a health clinic in Bamako, Mali. Credit: Dominic Chavez/World Bank.