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A national commitment to scaling up AMTSL – Mali’s experience. Dr Binta Keita Director for Reproductive Health. MALI. Population : 12,5 millions. ALGERIA. TOMBOUCTOU. TOMBOUCTOU. TESSALIT. ABEIBARA. GOUNDAM. TIN. -. ESSAKO. KIDAL. BOUREM. NIGER. MAURITANIA. MENAKA. GAO. DIRE.
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A national commitment to scaling up AMTSL – Mali’s experience Dr Binta KeitaDirector for Reproductive Health
MALI Population : 12,5 millions ALGERIA TOMBOUCTOU TOMBOUCTOU TESSALIT ABEIBARA GOUNDAM TIN - ESSAKO KIDAL BOUREM NIGER MAURITANIA MENAKA GAO DIRE GOURMA - RHAROUS NIAFUNKE ANSONGO YOUVAROU DOUENTZA YELIMANE NIORO NARA NIONO MOPTI TENENKOU DIEMA KAYES BANDIAGARA KORO MACINA SENEGAL BANAMBA KOLOKANI DJENNE BAFOULABE SEGOU BANKASS TOMINIAN KITA KOULIKORO SAN BARAOUELI BLA KENIEBA KATI KOUTIALA DIOILA YOROSSO BURKINA FASO KANGABA SIKASSO BOUGOUNI GUINEA distances en YANFOLILA KOLONDIEBA km KADIOLO 0 200 400 600
Introduction • Introduction of AMTSL in Mali: • Pilot project in Bamako in 2002/2003 demonstrated the feasibility and acceptability of introducing AMTSL in Mali • A national commitment was made to scale-up AMTSL to all facilities • At that time, only skilled birth attendants (doctors, midwives, and obstetric nurses) were included in scale-up activities • The DHS (IV – 2001) showed that auxiliary midwives (matrones) attend 45.3% of vaginal births • Up to 2009, matrones were not authorized to apply AMTSL
O1 Baseline August-October / 2006 O2 Evaluation November 07 / January 08 X Intervention September 06 - December 07 Operational Research: Feasibility and safety to train matrones to apply AMTSL
Follow-up of matrone study • Results of the study showed that: • Matrones could apply AMTSL competently and safely. • When matrones apply AMTSL, coverage of AMTSL can reach 100%. • Results were first presented at the national level and then to the Minister of Health and his staff
Change in policy The Minister of Health: • Authorized matrones to apply AMTSL on April 02, 2009 • Made a decision (No 09-1066/MS-SG du 22 mai 2009) to put in place a national commission to promote AMSTL • Requested that the commission: • Develop a national action plan for training matrones to apply AMTSL • Meet quarterly to follow progress made towards achieving the national plan
Interview des prestataires Interview matrones et des médecins
Thank you!!! Merci!!!!