Composting for Health Care
How a women’s group in Mali sustainably funds maternal and child health services in their community
It’s 7 a.m. on a Friday in the village of Kolosso, in Mali’s Segou region, and the sun is up. Members of the Benkadi women’s group have come together in the public square with buckets, shovels, and wheelbarrows to collect garbage.
They aren’t just cleaning the village. These women are gathering materials to make and sell compost, a valuable commodity in their region, and the profits will be used to fund improved health care access for mothers and babies in their community.
These funds are necessary because even though a new maternity center opened in Kolosso four years ago — reducing the distance needed to travel to access health care — most women in Kolosso could not afford its services.
“Despite the availability of primary health care and services, the mortality of children under 5, home births, frequency of diarrheal diseases, and respiratory infections remained very high,” said Sitan Dao, president of the Benkadi women’s group.
The physical distance between the population and the health center had been reduced, but financial barriers between it and the community remained.
Step One: Educating the Community
Over the past year, women’s access to the health center has improved with support from USAID’s Human Resources for Health in 2030 program. Aligning with the Government of Mali’s priority of improving maternal and child health, the program has developed a community approach to tap into the power of established women’s groups. The goal is to increase access to essential maternal, newborn, and child health care services.
To tackle high levels of maternal and child mortality in Kolosso, USAID’s trained community health workers not only oriented Benkadi members with key messages on mother and child health in the household, but also strengthened their skills in identifying problems and using local means to solve them.
Having acquired these skills, the women of Benkadi, with the support of the matron and community health worker, began to educate the community by emphasizing the importance of prenatal and postnatal consultations, the risk of home births, and the health services for children under 5, such as preventive care, immunizations, and nutrition.
Community health worker Batoma Souare helped the Bekandi women’s group pass this knowledge on to households. “Work with the women’s group strengthened communication on health within households,” Batoma said.
But even after learning how skilled care in a professional setting can save mothers’ and babies’ lives, the women of Kolosso still faced one final barrier to using the health center: the problem of cost.
Step Two: Women’s Problems, Women’s Solutions
Benkadi’s leaders identified a solution: The women set up a solidarity fund to cover the costs of prenatal consultations, maternal deliveries, and vaccinations for all village children. It is funded by a weekly contribution of 10 cents per woman, income from the sale of compost, and donations from some men in the community.
After eight months of regular contributions, the fund now has the capacity to finance Kolosso’s maternal and child health needs.
“I am no longer worried about my prenatal care at the health center thanks to our solidarity fund, which is covering my prenatal care and services entirely,” said group member Banana Dembele.
With this last barrier crossed, the maternity center is now physically and financially accessible. A vast majority of pregnant women in the village visit the center for prenatal care and delivery, and fewer children under 5 develop complications because neonatal and child care services are sought early and often.
“Thanks to awareness-raising within the community, and monitoring of pregnant women and children under 5 by members of the women’s group, we have not had a death in three months,” said community health promoter Amos Dembele.
USAID is working with more than 1,000 women’s groups in five target regions of Mali: Kayes, Koulikoro, Sikasso, Mopti, and Ségou. More than 300 of these groups, including the one in Kolosso, have set up solidarity funds to cover the costs of prenatal consultations, maternal deliveries, and vaccinations.
Over the past three years, USAID assistance through this project has enabled over 1.5 million women to access prenatal care, with more than 900,000 completing four prenatal visits and almost as many benefitting from postnatal care. Moreover, nearly 800,000 children in Mali have been monitored and treated by community health workers.
USAID is proud to partner with the Government of Mali in playing a transformative role in sustainably improving maternal and child health in the country.
About the Author
Ibrahima Kamaté is the Knowledge Management and Communications Officer with USAID’s Human Resources for Health in 2030 project in Mali.
