Bamako – “I was ashamed to talk about contraceptives because it is still a taboo subject in some circles where I live. I didn't want to be judged or have people in my neighbourhood talking about me,” says Kadidia, a 19-year-old student in Bamako.

Like Kadidia, thousands of young women in Mali face social, cultural and structural barriers to accessing sexual and reproductive health services. In 2024, the country recorded 583 maternal deaths, including 89 among adolescents aged 15 to 19. The risks associated with early and unwanted pregnancies remain high. The figures show an improvement, but also the scale of the work that remains to be done: the country had nearly 4.8 million women of reproductive age in 2024 and 559 493 young women and adolescents had access to modern contraceptive methods, compared with 480 682 in 2023.

Providing young women with appropriate and accessible reproductive health services is fundamental to their safety and future. By enabling them to make informed choices about their bodies and health, these services help reduce unwanted pregnancies, prevent sexually transmitted infections, and improve their physical and mental well-being. In a context where taboos persist and risks are high, guaranteeing these rights becomes a public health priority.

World Health Organization (WHO), with the support of a major donor, is assisting the Malian government in implementing a programme to improve rights and access to sexual and reproductive health care. The Organization's support includes strengthening the legal framework, improving the skills of health care providers, supplying medical equipment, setting up clinics tailored to the needs of young people, and producing reliable data to guide public policy.

"This programme is part of our strategic plan and aims to guarantee healthcare rights, particularly for young people and adolescents,” says Dr N'Tji Keita, Head of the Maternal and Child Health Department at the National Office for Reproductive Health. “We have been able to train magistrates on the new WHO guidelines, set up a national health observatory and strengthen the maternal mortality surveillance system."

WHO also support coordinating and supervision of activities. Thanks to the support, Mali has published its first national bulletin on sexual and reproductive health indicators, as well as the 2022 National Health Data. These facilitate better operational analysis and guide strategic decisions.

"We have supported the establishment of a Mother-Child-Adolescent clinic in Sikasso, which will offer integrated family planning and gender-based violence services. A mobile team is also ready to operate in Macina humanitarian zone. These initiatives aim to bring services closer to the most vulnerable populations," says Dr Sylla Ousmane, head of the Sexual and Reproductive Health Programme at the WHO office in Mali.

Trained and committed midwives are at the heart of the system improving adolescent girls’. “I have received several training courses on refocused prenatal consultations, family planning, STI/HIV/AIDS care and medical prescriptions. This has improved my performance and enabled me to welcome young women without judgement,” says Aïssata, a midwife.

Assetou, a mentor midwife in Yanfolila, about 160 kilometres south of Bamako, notes that “these training courses have brought about a big change in the way I work, particularly in terms of listening, availability and respect for consent.” Between 2019 and 2025, the number of young people and adolescents who have benefited from sexual and reproductive health services at her centre has more than doubled, from 2 330 to 5 121.

These improvements cannot be measured solely in numbers, but also in attitudes and behaviours. Thanks to awareness campaigns in schools, radio programmes on sexuality and training for healthcare providers on listening and respecting consent, young girls now dare to walk through the doors of health centres. Dialogue is opening up, taboos are receding, and trust is gradually being established.

For Kadidia, this transformation is tangible. She remembers her first visit to the health centre: “The lady who saw me made me feel at ease, listened to me without judging me and gave me good advice. I can say that this service contributes to our well-being. I want to say to young girls: ‘don't be afraid, go and seek advice, they are there to help us’,” says Kadidia.