Mali

Country Overview 

Malaria overview  

The whole of the Malian population is exposed to malaria, which is endemic in the central and southern regions, where about 90% of the population lives. The northern desert region experiences malaria in epidemics. Some 2.1 million malaria cases were reported in 2012, resulting in 1,833 deaths. Malaria is a leading cause of illness in Mali, and accounts for 42% of all outpatient visits to health centers.  

There are wide variations in malaria transmission patterns between Mali’s five climatic zones, ranging from year round transmission in the southern Sudano-Guinean zone, to short seasonal peaks in the Sahelian zone and occasional epidemics in the northern desert regions.  

Which areas of Mali are eligible for SMC? 

Most of central and southern Mali is eligible for SMC. The far southern region has a longer rainy season. Given that SMC administration can only continue for four months, this makes it unsuitable for this region.  

What is Mali’s experience with SMC? 

Prior to ACCESS-SMC, SMC had already been implemented in several districts of Mali. Five districts were supported by UNICEF and WHO, and another district was supported by the US Government’s President’s Malaria Initiative (USAID/PMI).   

ACCESS-SMC in Mali 

Where is SMC being delivered? 

In Mali, ACCESS-SMC is supporting the National Malaria Control Program (NMCP) to deliver SMC in 14 districts in 2015, reaching 866,294 children. The districts to be covered are: Bafoulabe, Diema, Nioro, Koulikoro, Fana, Djenne, Niono, Nara, Kadiolo, Yanfolila, Markala, Bougouni, Macina, and Douentza 

When is SMC being delivered? 

In Mali, SMC is delivered to children starting in August, with monthly distributions continuing until the end of October. In districts which are flooded in August, implementation will start and end one month later in order to avoid logistical problems.   

How is SMC managed?  

ACCESS-SMC is determined to build sustainable SMC delivery systems in Mali, to ensure rapid scale-up through this project can be maintained into the future. For this reason, SMC delivery is being led by the NMCP and fully integrated into regional and district health teams. ACCESS-SMC supports each of these levels with technical assistance, and logistical and financial support.   

How is SMC administered? 

In Mali, SMC is delivered over five days each month (a ‘cycle’) through 3,887 trained volunteer Community Health Workers (CHWs). CHWs deliver SMC using two methodologies: fixed post and mobile teams.  

• Fixed posts: This approach is used in large communities. Under this approach, CHWs administer SMC drugs to children at fixed administration points within the community. These include schools, Health Centers and other meeting points, designed to be convenient and accessible for parents and caregivers.   
• Mobile teams: In smaller or more dispersed communities, a mobile team approach is used, with CHWs travelling by motorbike to several communities each day to administer SMC.  

How do SMC drugs reach the ‘last mile’? 

ACCESS-SMC is working together with Pharmacie Populaire du Mali (PPM) to ensure drugs reach participating health facilities in time for SMC delivery. PPM is responsible for handling, storage and transport of the SMC drugs from the central medical stores down to the district medical stores. The district health team are responsible from here on for ensuring that the SMC drugs arrive at the Health Centers, from where CHWs collect them daily during the SMC cycle to administer to children. ACCESS-SMC has developed a logistics management information system (LMIS) which is being used in Mali to track commodities at each level of the health system.