Sexual and Reproductive
Health and Rights
Organisation

Date

Reporting Period

Embassy of the Kingdom of the Netherlands, Bamako (Mali)

Activity

2014

2014

Implemented by

Rio marker

Gender marker

Actual expenditure

Name Organisation

channel

mitigation/adaptation

significant/principal

significant/principal

Ministere de la Sante/DNS

Government

Not applicable

Not applicable

Principal

Number

Name

20228

Programma d’appui a l’acceleration de la 0
mise en oeuvre de l’OMD-5

22491

Consultant SR

2.788

Dr. D. Maiga

NGO

Not applicable

Not applicable

Principal

24586/7

Infrastructures Sante, ANICT
Mopti/Segou, Zone tampon

1.278.686

ANICT

Government

Not applicable

Not applicable

Significant

24589

ONUFemmes, prevention VBG droits
des femmes

935.476

ONUFemmes/UNWomen

Multilateral organization

Not applicable

Not applicable

Significant

26861

Riposte Ebola

1.402.531

Ministere de la Sante

Government

Not applicable

Not applicable

Significant

Activity

2014

Implemented by

Rio marker

Gender marker

Number

Name

Actual expenditure

Name Organisation

channel

mitigation/adaptation

significant/principal

significant/principal

25098

AMPPF 2013 - 2015

1.217.745

AMPPF

NGO

Not applicable

Not applicable

Principal

26169

POF Sante 2014

162.241

diverses ONGs + bureaus
d’etudes

NGO

Not applicable

Not applicable

Significant

26884

Manuel PRODESS III

334.105

OMS (Ministere Sante +
autres PRODESS)

Multilateral organization

Not applicable

Not applicable

Significant

25724

Elaboration PRODESS

47.449

Ministere de la Sante/CPS

Government

Not applicable

Not applicable

Significant

25738

FNSES Sante

5.300.000

Ministere d’Economie et
Finances (Min.Sante)

Government

Not applicable

Not applicable

Significant

26870

Programmes regionaux DEBBO ALAFIA

13 053 475

FCI/CAEB
AEN/AMSS et ASDAP

NGO

Not applicable

Not applicable

Principal

26628

DANAYA SO Mere-Enfants 2014-2018

1 524 490

Sex workers association
DANAYA SO

NGO

Not applicable

Not applicable

Principal

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Result Area 1

Young people are better informed and are thus able to make healthier choices regarding their sexuality

Result Question 1a: To what extent are young people better informed?
What evidence is there that they are making healthier choices regarding
their sexuality?

The most recent DHS of Mali was done in 2012. Only in the beginning of 2014 the data were being published as ’2012/2013’ data, however, data were collected in
2012. therefore these are reported as such. According to this 2012 Demographic Health Survey (DHS), the percentage of young people with comprehensive
knowledge of HIV has increased since the 2006 report. For young women between 15 and 24, the percentage went up by 31%, for young men even by 38%. This
is a major change, which is very likely linked to the strong increase in school enrollment over the last decade.
There are few recent data on the level of information of young people about HIV or broader sexuality issues, and none about changes in behavior. In fact, in the
Malian sociocultural context many young people can not decide about their own health and sexuality - especially girls. The more active attitude of youth in the
public debate in Mali exists and shows a positive trend, but by 2014 appears limited still to a relatively small group.
The regional SR programs (DEBBO ALAFIA - Segou, Mopti, Tombouctou) with their explicit focus on youth and rights issues has been well received by actors at
the local level as well as national counterparts. From individual encounters with youth activists it is clear that a growing group of capable, active youth are
developing. These two elements combined lead to careful hope that there will be more space for youth to speak out and youth who will know how to best use that
space.
Target 2017
Baseline
Result 2012
Result 2013
Result 2014
Source

Percentage using condoms at last high-risk sex, by gender and for age
15-19 specifically if possible (MDG indicator 6.2)

(2010)
Age 15-19: F: NA
Age 15-19: M: 27,4%

NA

-

No new data

No new data

Mixed Indicator Cluster Survey (MICS) 2010

Same

(2006)
Age 15-19:
F 13.7%
M 30.8%

NA

Age 15-19:
insuffic. numbers
F*; M**

-

-

Demographic and Health Survey (DHS) IV (2006) and
V (2012) definitions differentes
*F 15 - 49 = 9.9% ; **M 15 - 24 = 38%

Percentage of young people (15-24 ) with comprehensive correct
knowledge of HIV/aids (MDG indicator 6.3)

(2010)
Age 15-24: F: 14,6%
Age 15-19 : F 14,4%

NA

-

-

-

MICS 2010

Same

(2006)
Age 15-24: F 17,9%
M 22,2%

NA

Age 15-24:
F 23.7%
M 33.0%

-

-

DHS IV (2006) and V (2012)

Result Question 1b (1): With which results has your programme
contributed to comprehensive sexuality education for young people in and
outside of school?
Result Question 1.b (2): With which results has your programme contributed
to opportunities for young people to have their voice heard and stand up for
their rights?

The major counterpart for comprehensive sexuality education is AMPPF, the Malian member organization of IPPF. AMPPF has a strong youth movement that is
important to reach out to young people. In addition, AMPPF pursues the free-of-charge SMS information service, and other information channels. There are active
youth groups in all regional offices throughout Mali. Services delivered by AMPPF focus more and more the young segment of the population. The Gao office in
North Mali has restarted its activities; the youth group functions.
DANAYA SO is a local association created by Malian sex workers (SW) to stand up for their rights. In their implementation policy, one of the main actions is
coaching young SW (under 18) by adults to be educated in sexuality, as well as the teenager sons and daughter of SW. They received informations on their rights
and are trained to improve their capacities to defend their rights.
A new program named DEBBO ALAFIA, witch began in November 2014 in three regions of Mali (Segou, Mopti and Tombouctou, emphasizes youth participation
mainly as actors for change in general, and specifically to support them to develop their own innovative activities to make their voice heard and to fight for their
rights at different levels.
Baseline
Result 2012
Result 2013
Result 2014
Source
Target 2017

Number (or %) of youth-friendly (health) centres

NB, data are taken from different (international) surveys and are not always comparable. For instance, it can not be excluded that in fact women get pregnant
7 (in 4 in
of their
9
in young
9 regions
6 youth
yth centres
MJSP,
Minconfirm
de la Jeunesse
(2011),
earlier
lifetime20
- as
girls - but -the available figures from
the centres
2 surveys with6 different
methodologies
cannot
this; specially
theNGOs
difference
regions) the two data(MJSP)
(AMPPF alone)
AMPPF, 12 yth
between
points cannot be taken as absolute.
clubs Tombouctou

Number of youth (10-24) using sexual and reproductive health
services by organisation supported

AMPPF services
21% youth focus
MSI 50% youth

NA

-

417 269 = 53% all
clients ; includ.
1491 post-ab. care

Percentage of young girls (15-19) that are pregnant or have a child

(2010) 33,4 %
(44.5% poorest
percentile)

-

39.3%
(46.1% poorest
quintile)

-

Number of young mothers coached in youth groups

522 798 = 65% all
AMPPF ; 219 SW
10-24 yrs on PF

NGO reports:
2013 - AMPPF
2014 - AMPPF. Danayaso

MICS 2010
DHS V (2012)

37, of which 31
treated for fistula

2014, Debbo Alafia, Tombouctou

Assessment of results achieved by NL across the entire Result area 1

Young people are better informed and are thus able to make healthier choices regarding their sexuality

B.

The political and security crisis in the country has made the focus on positive change in the lives of young people a posteriority of activities and for instance data
collection has suffered from a reduction and re-allocation of donor funding as well as less attention from Malian leaders.
At the same time, Mali remains a traditional society, even more so in the rural areas, where young people have to show respect to their elders and are not
expected to present their own views. It is therefore not easy for young people to (think that they can) make a difference. However, changes are taking place,
starting in urban centers such Bamako and Mopti. In youth groups men tend to be more active than girls, but some young women play key roles as well.

Results achieved as planned

Reasons for results achieved:

Implications for planning:

In the current context of political crisis, fragility, and religious conservatism, it has become more difficult to have divergent views. This works out negatively for
decision making and reflection space for young people. AMPPF plays a positive role in this regard. Their youth groups are well known in the country, and are
frequently invited to take part in or even lead activities from other organisations.
The Embassy continues to use a regional approach with local actors to support communication within the community, within families and between generations,
with the objective to promote change, both in terms of behavior as in views on rights of individuals and social relations in the society. This will require in-depth
community work with a focus on the rights of women, youth and especially girls, all relatively unknown concepts in Mali currently.

Result Area 2
Result Question 2a: To what extent do more people have access to
anti-retroviral drugs, contraceptives and other commodities required for
good sexual and reproductive health?

A growing number of people have access to anti-retroviral drugs, contraceptives and other commodities required for good sexual and reproductive health
The contraceptive prevalence rate, which remained more or less the same at 5-6% during the period 1995 - 2006, increased to 10% according to the 2012 DHS.
There is, however, still a high level of unmet need for family planning, meaning that the prevalence would increase with improved service delivery. The crisis has
influenced this negatively for the years 2012 and 2013, but currently activities are picking up. The uptake of hormonal implants is remarkably high, especially
among young people, while the use of IUDs, in locations where staff capable of handling them is available, is also increasing. These long-acting methods have
already had an impact on the couple-years of protection (CYP) rate that nearly doubled between 2010 and 2012. The unmet need remains high at 26% of 15-49
year old married women, of which 18.6% would like to use contraception for child-spacing according to the DHS V (2012).
During the finalization of the new health program PRODESS III a number of new documents and indicators were developed and set. Unfortunately the ministry of
health, after technical discussions judging a 20% target (2018) realistic, decided to reduce its ambition to 15% in 2018. With partner dynamics affected by the
period of crisis, suspensions and humanitarian approaches, the partner group has not been able to discuss this issue meaningfully with decision makers in the
government.

Baseline

Target 2017

Result 2012

Result 2013

Result 2014

Source

9.6% of all women
15 - 49

-

155 SW on FP

DHS IV (2006) ; V (2012) - 2012: 9.9% married
women / 33.5% unmarried sexually active women
(=few) 2014 Danayaso

Contraceptive Prevalence Rate - modern methods- all women 15-49

13% (PRODESS
(2006)
6.2% of all women III)

Contraceptive Prevalence Rate - modern methods- all girls 15-19

(2006) 3.4% all
girls 15-19
(5.8% married gir)

NA

5.5% all girls 15-19 (6.5% married
girls)

-

DHS IV (2006) and V (2012)

Unmet need for family planning of women 15-49 years old

(2006) 31,2% of
married women

NA

26.0% of married
women
23.3% all women

-

-

DHS IV (2006) and V (2012)

Unmet need for family planning of girls 15-19 years old

(2006) 35,4% of
married women

NA

23.3% of married
girls 15 - 19
14.5% all girls

-

-

DHS IV (2006) and V (2012)

Result Question 2b (1): With which results has your programme contributed
to a greater choice in and sufficient availability of contraceptives/medicines?
Result Question 2b (2): With which results has your programme
contributed to addressing sociocultural barriers preventing women from
using contraceptives?

The crisis in 2012 threatened the availability of long-acting method, such as implants, as well as of C-section kits and blood transfusion materials. The main
reason was that all large funders and importers of contraceptives had halted their funding : USAID and KfW. A rupture was avoided through a targeted contract
with the national drugs procurement agency (Pharmacie Populaire du Mali) that bought the contraceptives needed, which are usually brought in through donor
contributions.
The Embassy provides financial support to AMPPF, which is a major player in contraceptive distribution, with a focus on young people. They provide over 2 million
condoms annually and carry out communication as well as in some communities around the regional and Bamako clinics.
In addition a program with the ministry of health has continued to give some results through 2013, as funding available early 2012, before central government
could not be resourced, was still put to good use: the national protocols on Reproductive health were developed and quite progressive, for instance on adolescent
reproductive health services to be offered. These new protocols now need to be implemented. The same program included funding of MSI by the ministry of health
for mobile clinics that included an important communication element.
Baseline
Result 2012
Result 2013
Result 2014
Source
Target 2017

Optional: number of health products distributed (crisis funding to
national pharmacy)

NA

NA (crisis funding)

Number of couples protected by various contraceptives (Couple Year
Protection = CYP)

(2010)
139.830

NA

Number of condoms distributed
- male condoms
- female condoms

male: 2 200 268
female: Not
available

Number of people being treated with anti-retroviral drugs (paediatric
cases + adults)

63% paediatric
cases
SLIS 2012

C-section: 15569
implants: 31000
blood t.: 108000

-

Pharmacie Populaire du Mali ; 2013 seulement

264.230

382.408

111.268 only
15-24 yrs

Systeme Local d’Information Sanitaire (SLIS)
2010 / 2012 / 2013
2014 AMPPF (youth=pas comparable 2012 / 2013)

NA

-

male: 2 484 546
female: Not
available

male :3.879.332
(AMPPF) ;
132.160 SW

AMPPF - report 2013, 2014
Danayaso 2014

NA

26.839 adults
1.912 children

28.725 tout age
confondu

35 SW on ARV

SLIS - Patients coming for regular follow-up on ARVs
2014 Danayaso

Assessment of results achieved by NL across the entire Result area 2

A growing number of people have access to anti-retroviral drugs, contraceptives and other commodities required for good sexual and reproductive health

B.

The donor support has picked up in 2014, inclluding through NGOs like MSI / PSI that can import contraceptives, as well as the economy and specially the
government budget for the health sector including commodity procuring. The Global Fund grant, managed by UNDP, has continued procuring all needed ARVs.

Results achieved as planned

Reasons for results achieved:

Implications for planning:

As there is sufficient funding of ARVs through the Global Fund, the Embassy will not invest in them. Good planning of contraceptive funding remains a challenge,
with UNFPA does not fully fulfil its mandate to coordinate this field. The pulling out of KfW of funding contraceptives seems to have been offset by other donors,
mainly EU and USAID. The Embassy will follow closely the availability of contraceptives and other relevant commodities. If required due to commodity
procurement/management weaknesses; includinge the target that may prove too low in relation to contraceptive need / uptake - the embassy will be providing
financial support.

Result Area 3
Result Question 3a: To what extent has the use of sexual and reproductive
healthcare services in the public and private sector improved?

Antenatal care coverage of at least one visit (MDG indicator 5.5)

Public and private clinics provide better sexual and reproductive healthcare services, which more and more people are using
Many indicators have shown improvements since the early 2000s. The policy focus in antenatal care has changed around 2010 on increasing utilization of
services in general to reaching a minimum of 3 (or 4) visits per pregnancy, and in timely fashion, The most significant change since 2010 concerns the % of
pregnant women undertaking at least 4 visits for prenatal care. Births attended by skilled personnel has also increased considerably in this period, although one
has to consider the wider definition of ’skilled personnel’ for the 2013 data. These changes are mainly the result of increased geographic coverage of infrastructure
which is made more up to standard for adequate reproductive services, as well as a considerable increase in higher medical cadre available in these health
centers - with midwives in rural areas lagging behind.
However, the crisis and occupation in 2012 had a major impact on service availability and use in the 3 northern regions and some districts in the Mopti region.
Service availability continued improving by end 2014 in the major towns in those regions, as well as in most of the Mopti region, but due to continued insecurity
large areas in these regions were still not (regularly) reached. The Ebola crisis in neighboring Guinea, Liberia and Sierra Leone, leading to 2 relatively small
clusters of cases in Mali, disturbed the implementation of PRODESS III in the 2nd half of 2014. A considerable part of donor funding has still been focused in 2014
(and still) on humanitarian
like malnutrition
clinics.
The harmonization
of these approaches
Targetissues
Baseline
2017 and approaches,
Result 2012
Result
2013
Result 2014
Source with the implementation of PRODESS III has to
be worked on, specifically in the northern regions, where free services are implemented by humanitarian organizations. The northern regions population’s current
access to free services is patchy, but in any case the transition to paid services according to PRODESS implementation will have to be prepared carefully.
(2006) 70%
NA
74%
74%
MICS 2010; DHS IV (2006) and V (2012)
(2010)
73,6%
SLIS 2013
For
2014
no data are available yet. In fact the numbers in below table for the different years cannot be compared
directly. DHS V was not carried out in the 3

Antenatal care coverage of at least four visits (MDG indicator 5.5)

northern regions and the ’total’ figures therefore only cover the 5 ’southern’ regions + Bamako ; while this was when least services were available in the excluded
regions - The DHS V has some overestimation. The 2013 SLIS correctly still shows low rates of coverage of some indicators in these regions (antenatal 3+ /
(2006) 35.4%
60%the
at national
least 3 average
41%
38%
MICS 2010; DHS IV (2006) and V (2012)
delivery),
bringing down
as you can see below.
(2010) 34,9%
visits (PRODESS
SLIS 2013
III)

Proportion of births attended by skilled health personnel (MDG
indicator 5.2)

(2006) 26.8%
(2010) 29,1%

56% (PRODESS
III)

40%

48%

-

MICS 2010; DHS IV (2006) and V (2012)
SLIS 2013 (definition ’skilled’ incl..lower level staff)

Proportion of births attended by skilled health personnel of 20%
poorest

(2006) 9.1%
(2010) 9%

NA

17%

-

-

MICS 2010; DHS IV (2006) and V (2012)

Result Question 3b (1): With which results has your programme contributed
to improved cooperation between public and private healthcare services?
Result Question 3.b (2): With which results has sexual and reproductive
health care including emergency obstetric care become more affordable and
accessible?

Embassy results have contributed to strengthen the functioning of the health sector as a whole through a number of actions. 1. technical and financial support
towards the adoption of a new 10-year health plan and 5 year program "PRODESS III" mid 2014; 2. fund the Fond National de Stabilisation Economique et Social
to ensure a.o. funding for budgetlines implemented by local government for health staff and activities in their community ; 3. support the ministry of health in its
efforts to prevent an ebola epidemic (1 confirmed case = epidemic) in the country, and from october 2014 manage 2 clusters of ebola patients (Mali was declared
Ebola Free early 2015). An operational problem at another donor led to temporarily covering a program for SRHR services for homosexuals by an AIDS NGO.
Policy dialogue around the ambition and adequate implementation of SRHR priorities as part of the PRODESS III have been ongoing, while the continued support
to the national IPPF affiliate and Danayaso (association of sex workers) resulted in services at their level as well as their inputs into national dialogue about
ambition and implementation of SRHR policies.
The private for profit health sector in Mali concerns mostly the pharmaceutical sector. Some private clinics exist in Bamako and the regional capitals and are only
used by the top income layer, except for non-profit NGO clinics for Aids-diagnosis and treatment, and NGOs like AMPPF that propose a range of family planning
services. The privateTarget
pharmaceutical
sectorResult
is widely
used, and referred
to; however national
public sector capacity
Baseline
2017
2012
Result 2013
Result 2014
Source to sufficiently regulate, inspect, and support
the private pharmacies is weak, as is quality assurance in public facilities.

Number of doctors, nurses and midwives per 1000 inhabitants

(2010) per 1000:
0.1 doctor; 0.05
midwive; 0.3 nurse

PRODES III - per
1000: 0.25 doctor /
midwive; 0.4 nurse

per 1000: dr 0.05 0.3 ; m 0.03 - 0.2 ;
nurse 0.1 - 0.7

per 1000: dr 0.02 0.3; mw 0.03 - 0.2;
nurse 0.1 - 0.7

-

Systeme Local d’Information Sanitaire SLIS 2010 /
2012 / 2013
(2012/2013 = range - only regional data available)

Number of midwives/ skilled birth attendants trained

NA

NA

about 350
midwives trained

-

-

from Institut National de Formation en Sciences de
Sante (INFSS) NICHE project document - currently
379 midwife students)

Access to basic emergency obstetric care (BeMOC) per 500,000
population

(2006) 52/785 =
6.6% of health
centers

PRODESS III :
15% of health
centres

81/1134 = 7.1% of
health centers

no new data (1170
health centers)

-

SLIS 2010, 2012 and 2013

Assessment of results achieved by NL across the entire Result area 3

Public and private clinics provide better sexual and reproductive healthcare services, which more and more people are using

B.

In 2013, during the extended political crisis and the retaking of most of the northern regions by Malian and French forces, the health sector did not see much direct
funding outside of the UN. The national budget funding of health activities (in addition to salaries that were paid in full in 2012) returned closer to pre-2012 levels.
The embassy focused its support on development of the national health programme, which would form the basis of any funding in the sector. The PRODESS II
had been adopted in 2005/6 and needed review, based on the external evaluation carried out in 2011, and the lesson’s learned from the crisis. The PRODESS III
was adopted in juin 2014.

Results achieved as planned

Reasons for results achieved:

While the new health program was developed, funding of the Fonds National de Stabilitsation Economique et Social, and a contribution to the cost of public sector
activities for prevention and management of the ebola epidemic in Mali, supported to maintain the capacity in the health sector to deal with the most important
issues. The development of the new programmes specifically for SRHR issues, like funding for Danayaso, the sex worker association, and Debbo Alafia, the
regional programs in Segou, Mopti and Tombouctou will help give direction to reach more specific results on SRHR.

Implications for planning:

Continue the development of the regional program Debbo Alafia for the Gao region to cover the NL focus regions.
Develop aligned funding for PRODESS III that is based on lessons from the crisis and from the 2011 evaluation. The revision of the PRODESS III procedures
manual is an important activity to help clarify and streamline procedures; the process of the revision will be used for policy dialogue on the need to increase the
results focus of the public sector in its implementation of the PRODESS III.
The Embassy will critically follow the Debbo Alafia regional programs to ensure that the capacity of local actors will be strengthened for communication with
communities for behavioral change in harmful practices such as female genital mutilation/cutting and child marriage. Communities, NGOs and youth associations
will be encouraged to work together to promote familly planning and broader gender and health advocacy at differents levels. Through these programs the
capacity of public and private clinics will be impoved to provide quality services in sexual and reproductive health and rights.

Result Area 4

Greater respect for the sexual and reproductive rights of people to whom these rights are denied

Result Question 4a: To what extent have the conditions for women, young
people, sexual minorities, sex workers and intravenous drug users improved
with regards to their sexual and reproductive rights?

In 2014 no major changes were made to laws with regard to sexual and reproductive health and rights. In the press, but also during workshops, the position of
marginalized groups, such as LGBT, was discussed, sometimes in a negative way, but also from a more positive outlook. The fact that SRHR issues are being
discussed including rights of individuals - like also young girls, provides a basis to work with local actors interested to defend the human rights of all Malians.
Note that the general figure on female genital mutilation (FGM) from the 2012 DHS is higher than the 2006 DHS as a result of exclusion of the occupied northern
regions in 2012 where FGM is less common - a comparison per region shows that most regions covered in 2012 actually had slightly reduced levels of FGM in the
six year period. The same can be said for early marriage with an average increase of the age at first marriage of 1 year in each region with the national average
age changing from 16.6 to 18.0 (for women between 25 - 49 years). The change is taking place; the current objective is to increase its pace.

Percentage of women married before age 18 in 20-24 year age group

Percentage of female genital mutilation in 20-24 year age group

Result Question 4b (1): With which results has your programme contributed
to the identification of or changes in legal and policy barriers for the sexual
and reproductive health of women, young (unmarried) people, sexual
minorities, intravenous drug users and sex workers?
Result Question 4b (2): With which results has your programme contributed
to improving the access of these specific groups to sexual and reproductive
health services and commodities?

The occupation in the north impacted women’s and youth’ rights in the short term as a result of sexual violence and cruel sharia (corporal) punishment. There has
been a general outrage against these practices, and some activities in support have been developed - 80 cases have been presented to the courts by human
rights defenders. Women and specifically girls still fear to openly speak out on this issue and it is not sure that court cases will really be able to adequately judge
perpetrators - also due to the weaknesses in the justice system.
Target 2017
Baseline
Result 2012
Result 2013
Result 2014
Source
Many activities have been developed by different partners to address issues that affect women, including in addition to the above, also explicitly child marriage, the
prevention and treatment of fistula, FGM as well as the overfeeding of girls to be able to marry them off earlier.
(2006) 70.6%;
NA
59.6%
DHS IV (2006) and V (2012) and MICS 2010
(2010) 55.0%

(2006) 84.5%;
(2010) 88.2%

NA

91.5%; per region
decline 2 - 4%,
except Mopti

-

-

DHS IV (2006) and V (2012) and MICS 2010
DHS V excludes north which has less FGM !

The political and social climate does not favor major changes in laws and policies. Mali does not have a law that makes FGM or child marriage punishable. The
official age for marriage is still 16 years, though in practice in some regions girls are still married at much younger ages. AMPFF is a major player to open up
dialogue on these issues, with expansion in 2012 into more regions and working at the university. The Embassy is in contact with the LGBT movement. Insecurity
and political instability were still important in 2014 and continue.
In Tombouctou it was noted,that a number of religious leaders are including positive messages in their sermons; declarations and testimonies against child
marriage as well as female genital mutilation are given on local radio and elsewhere. These declarations have been coming from communities where the practices
are rooted very strongly.

Baseline

Target 2017

Optional: Perceived change in public statements made by leaders /
personalities advocating for sexual and reproductive rights: of women,
young (unmarried) people, sexual minorities, sex workers and
intravenous drug users
Optional: Number of communities / local leaders that have denounced
childmarriage

NA

NA

Planned for 2014
for Segou, Mopti
and Tombouctou

NA

Optional: Number of communities / local leaders that have denounced
female genital mutilation

Planned for 2014
for Segou, Mopti
and Tombouctou

Optional: Number of key populations having received sexual and
reproductive health services and information

Planned for 2014
for Segou, Mopti
and Tombouctou

Result 2012

Result 2013

Result 2014

Source

Positive statement
done by regional
president in Segou

Tombouctou
multiple, see text

2013/2014 Debbo Alafia

-

-

-

NA

-

-

-

NA

-

-

155 on family
planning ; 132.160
condoms; 35 ARV

Danayso 2014.

Assessment of results achieved by NL across the entire Result area 4
C.

Greater respect for the sexual and reproductive rights of people to whom these rights are denied

Results achieved poorer than planned

Reasons for results achieved:

Implications for planning:

In the Malian context we may and cannot expect quick results, and the continuing insecurity and political instability make it more difficult to achive results. The
crisis has underlined the fact that most Malians have a tolerant view of the Islamic religion. At the same time, that tolerant view is under (external) pressure and at
the same time there is some cry for returning to Malian traditions that might be more intolerant and less rights-based than the Malian society actually was.
Some careful positive change continues, in more public discussion of rights of children and young people; of the emergence of a movement of sexual minorities in
Mali; of the continued attention to deal with rape and other violence against women. All these issues, the Malian people now have more difficulty ignoring and they
are discussed in workshop, on social media and gatherings, and in the newspapers. This provides an important opportunity. However the programs to make use of
these opportunities have only been developed in 2014 and 2015, as before the focus was on crisis management and prevention of loss of existing capacity in the
public sector and NGOs that deal with SRHR issues.

To enable social change, it is necessary to focus on communication within the community, within families and between generations. Part of that work will require
involvement of women, youth and especially girls, which is still not common in Mali currently. Although Mali’s demographic structure means that a majority of the
population is under 25, it is still uncommon for young people to become active agents and not only a target group. They need to be involved in developing their
own projects at local level and in implementing sexuality education at the local level. Also, given the sensitivity of these issues in the Malian context, it is often
more strategic to facilitate the local more liberal voices than opting for strong involvement from the Netherlands.

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