Publication: Cultural Resources and Maternal Health in Mali
Loading...
Date
1999-09
ISSN
Published
1999-09
Author(s)
Editor(s)
Abstract
In spite of the cultural, traditional taboo on the subject of pregnancy in most African households, the success of the Africare's Child Survival Project in Mali, documents the increased communication, and behavior changes in health seeking during pregnancy. Africare is a US-based private, voluntary organization, working in community development, and through its efforts, constructed a maternity ward in the country, supported by government health professionals. The note describes the research work underwent by Africare to identify both resources, and obstacles related to to improved maternal health, and care-seeking. Findings revealed that both women, and men were well aware of the risks associated with pregnancy, enhanced by cultural traits which places a strong value on supportive husbands during pregnancy. However, one of the most striking cultural obstacles to women's maternal health care, was the absence of discussions on the subject, due entirely to the taboo issue about sexual relations, and pregnancy. Following a pilot maternal health campaign - based on cultural, traditional channels in identifying maternal, and pregnancy issues - the impact of the project was evaluated, demonstrating those channels used to communicate, can be effectively innovated to adapt them to modern needs.
Link to Data Set
Citation
“Clemmons, Lydia; Coulibaly, Yaya. 1999. Cultural Resources and Maternal Health in Mali. Indigenous Knowledge (IK) Notes; No. 12. © World Bank. http://hdl.handle.net/10986/10826 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Addressing Adolescent Sexual and Reproductive Health in Niger(World Bank, Washington, DC, 2016-01)The aim of the study is to better understand adolescents’ sexual and reproductive health (SRH) needs in order to inform the design of interventions and policies that improve access to and use of adolescent SRH services in Niger. A mixed-methods study was conducted and included: (i) a quantitative analysis of Niger’s Demographic Health Survey/Multiple Indicator Cluster Survey (DHS/MICS) 2012; (ii) 17 focus group discussions conducted in urban and rural areas among 128 adolescents; and (iii) a set of recommendations to improve access to and use of SRH services for adolescents in the country. The study found that age at first marriage among adolescent females is 15.7 years and is followed soon thereafter by sexual debut (15.9 years). According to focus group discussions (FGDs), adolescent’s boys and girls start spending time together at 12 years in urban areas and 10 years in rural areas; this may lead to sexual intercourse in exchange for material and financial resources. Over 70 percent of adolescents have given birth by 18 years of age. Although knowledge about modern contraception is high (73 percent among female adolescents 15-19 years of age), the majority of adolescent girls do not use contraception due to societal and cultural beliefs. Moreover, FGDs reveal that the main barriers to use of SRH services is a lack of privacy and confidentiality, as well as finances, despite the government’s elimination of user fees. The government has increased supply side interventions for adolescents and prioritized adolescents on the national agenda by approving the Family Planning Action Plan (2012-2020) and the National Plan for Adolescent Sexual and Reproductive Health (2011), however these plans need to be monitored and evaluated to determine their effectiveness in reaching this population group. There is also a need to increase multi-sectoral demand-side interventions in the country.Publication Demand-side Financing for Sexual and Reproductive Health Services in Low and Middle-Income Countries : A Review of the Evidence(World Bank, Washington, DC, 2012-10)Demand-side financing approaches have been introduced in a number of low and middle-income countries, with a particular emphasis on sexual and reproductive health. This paper aims to bring together the global evidence on demand-side financing mechanisms, their impact on the delivery of sexual and reproductive health services, and the conditions under which they have been effective. The paper begins with a discussion of modalities for demand-side financing. It then examines 13 existing schemes, including cash incentives, vouchers, and longer term social protection policies. Based on the available literature, it collates evidence of their impact on utilization of services, access for the poor, financial protection, quality of care, and health outcomes. Evidence on costs and cost-effectiveness are examined, along with analysis of funding and sustainability of policies. Finally, the paper discusses the preconditions for effectiveness of demand-side financing schemes and the strengths and weaknesses of different approaches. It also highlights the extent to which results for sexual and reproductive health services are likely to be generalizable to other types of health care. It is clear that some of these policies can produce impressive results, if the preconditions for effectiveness outlined are met. However, relatively few demand-side financing schemes have benefited from robust evaluation. Investigation of the impact on financial protection, equity, and health outcomes has been limited. Most importantly, cost effectiveness and the relative cost effectiveness of demand-side financing in relation to other strategies for achieving similar goals have not been assessed.Publication Maternal Mortality(Washington, DC, 2006-05)Over 529,000 women die annually from complications during pregnancy, childbirth, or the postpartum period. Nearly all of these deaths occur in developing countries, where fertility rates are higher and a woman's life time risk of dying during pregnancy and childbirth is over 400 times higher than in developed countries. Additionally, an estimated 20 million women endure lifelong disabilities such as pelvic pain, incontinence, obstetric fistula, anemia and infertility. The main direct causes of maternal death are severe bleeding, unsafe abortion, infection, eclampsia, and obstructed labor; the indirect causes include anemia, malaria, heart disease, and HIV. Pregnancy complications are the main cause of death for women aged 15-19. High maternal mortality rates in many countries result from poor reproductive health care, including not having access to skilled care during pregnancy and childbirth and access to safe abortion even where it is legal, especially for the poorest women. Risks of poor outcomes during pregnancy and childbirth are exacerbated by poverty, low status of women, lack of education, poor nutrition, heavy workloads and violence. While many factors contribute to maternal death, one of the most effective means of preventing maternal health is to improve health systems and primary health care to ensure availability of skilled attendance at all levels and access to 24-hour emergency obstetric care. Family planning services could also reduce maternal deaths and morbidities by 30 percent. Prevention of unwanted pregnancies and access to safe abortion as allowed by law and post abortion care services could reduce maternal deaths and injuries caused by unsafe abortions - over 68,000 women die from unsafe abortions annually.Publication Age at First Child Does Education Delay Fertility Timing? The Case of Kenya(2009-02-01)Completing additional years of education necessarily entails spending more time in school. There is naturally a rather mechanical effect of schooling on fertility if women tend not to have children while continuing to attend high school or college, thus delaying the beginning of and shortening their reproductive life. This paper uses data from the Kenyan Demographic and Health Surveys of 1989, 1993, 1998, and 2003 to uncover the impact of staying one more year in school on teenage fertility. To get around the endogeneity issue between schooling and fertility preferences, the analysis uses the 1985 Kenyan education reform as an instrument for years of education. The authors find that adding one more year of education decreases by at least 10 percentage points the probability of giving birth when still a teenager. The probability of having one's first child before age 20, when having at least completed primary education, is about 65 percent; therefore, for this means a reduction of about 15 percent in teenage fertility rates for this group. One additional year of school curbs the probability of becoming a mother each year by 7.3 percent for women who have completed at least primary education, and 5.6 percent for women with at least a secondary degree. These results (robust to a wide array of specifications) are of crucial interest to policy and decision makers who set up health and educational policies. This paper shows that investing in education can have positive spillovers on health.Publication The Determinants of HIV Infection and Related Sexual Behaviors : Evidence from Lesotho(World Bank, Washington, DC, 2007-12)This paper analyzes the socioeconomic determinants of HIV infection and related sexual behaviors using the 2004 Lesotho Demographic and Health Survey. The authors find that in Lesotho education appears to have a protective effect: it is negatively associated with HIV infection (although not always significantly) and it strongly predicts preventive behaviors. The findings also show that married women who have extra-marital relationships are less likely to use a condom than non-married women. This is an important source of vulnerability that should be addressed in prevention efforts. The paper also analyzes HIV infection at the level of the couple. It shows that in 41 percent of the infected couples, only one of the two partners is HIV infected. Therefore, there are still opportunities for prevention inside the couple.
Users also downloaded
Showing related downloaded files
Publication Guide to the Debt Management Performance Assessment Tool(Washington, DC, 2008-02-05)The purpose of this document is to provide guidance and supplemental information to assist with country assessments of debt management performance, using the Debt Management Performance Assessment (DeMPA) tool. The DeMPA is a methodology used for assessing public debt management performance through a comprehensive set of 15 performance indicators spanning the full range of government Debt Management (DeM) functions. It is based on the principles set out in the International Monetary Fund (IMF) and World Bank guidelines for public debt management, initially published in 2001 and updated in 2003. It is modeled after the Public Expenditure and Financial Accountability (PEFA) framework for performance measurement of public financial management. The DeMPA has been designed to be a user-friendly tool to undertake an assessment of the strengths and weaknesses in government DeM practices. This guide provides additional background and supporting information so that a no specialist in the area of debt management may undertake a country assessment effectively. The guide can be used by assessors in preparing for and undertaking an assessment. It is particularly useful for understanding the rationale for the inclusion of the indicators, the scoring methodology, and the list of supporting documents or evidence required, and the questions that could be asked for the assessment.Publication Mexico Poverty and Equity Assessment(Washington, DC: World Bank, 2025-02-20)This Mexico Poverty and Equity Assessment reviews the evidence about poverty and equity in Mexico over the last two decades, compares it to comparable international experience, and identifies a set of critical areas of policy intervention to answer the opening question. The report aims at contributing to an open conversation in Mexico about how to achieve this essential policy objective. This report postulates three main policy areas needed for poverty eradication in Mexico: inclusive growth, efficient social policy, and infrastructure to confront vulnerability. The report includes four sections, the first three of which collect evidence about poverty, social deprivations, and vulnerability and how the evolution of these three correlates to patterns of economic growth, social protection policy and territorial development. The fourth section provides some quantitative benchmarks of what it would take to eradicate extreme poverty in Mexico. Poverty in Mexico is defined not only in monetary terms, but also in a multidimensional manner that includes social deprivations. These are social deprivations that often define formal-vs-informal employment, so policy changes that close these carencias, as they are called in Mexico, will also reduce the informality gap. This report documents the evolution of poverty, social deprivations, and vulnerability to poverty. It explains the main forces that have driven this evolution and advises that many of these forces may not operate the same in the future as they did in the past. It provides the basis to argue that short to medium term extreme poverty eradication requires newer policy actions in terms of inclusive growth, more efficient social policy, and investments in physical and social infrastructure to reduce vulnerability. The report indicates that short to medium term eradication to extreme poverty is a major, but within reach, development challenge for Mexico.Publication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.Publication Financing Firm Growth(Washington, DC: World Bank, 2025-03-13)Well-functioning capital markets can foster economic growth and allocate resources efficiently. Firms can tap into a broader funding base by issuing debt and equity in capital markets, often at cheaper rates and longer tenors than through other sources of external finance, such as banks. However, capital markets in low- and middle-income countries have lagged those in high-income countries. Accordingly, the firms in those countries have more often relied on bank financing or retained earnings to fund investment and expansion, and they have experienced greater financial constraints than their counterparts in high-income countries. Financing Firm Growth: The Role of Capital Markets in Low- and Middle-Income Countries shows that the gap in capital market financing between low- and middle-income countries and high-income countries has narrowed, with resulting benefits for both the firms accessing those markets and for the countries in which they operate. The analysis reveals greater participation by firms from low- and middle-income countries in capital markets since the 2000s. Most of these firms are new participants in capital markets, and they tend to be smaller, younger, and more productive than those already participating. Firms are deploying capital raised in markets to become more productive—investing in physical assets, hiring more workers, and expanding operations, spurring growth both at the firm level and within their economies. To reach these findings, the analysis used a novel database of the universe of bond and equity issuances from companies between 1990 and 2022. The insights leverage data from nearly 80,000 firms worldwide, focusing on how 20,000 firms across 106 low- and middle-income countries access and use capital market financing. --- “Financing Firm Growth is a groundbreaking exploration that delves into the vital role that capital markets play in driving business expansion in low- and middle-income countries. Backed by data from 80,000 firms across 147 economies, the authors explore the factors underlying capital market growth and its benefits for economies and firms at all levels of development. This book is a must-read for investors, policy makers, and economists shaping the future of global finance.” — Laura Alfaro, Warren Alpert Professor of Business Administration, Harvard Business SchoolPublication The Mexican Social Protection System in Health(World Bank, Washington DC, 2013-01)With a population of 113 million and a per-capita Gross Domestic Product, or GDP of US$10,064 (current U.S. dollars), Mexico is one of the largest and highest-income countries in Latin America and the Caribbean (LAC). The country has benefited from sustained economic growth during the last decade, which was temporarily interrupted by the financial and economic crisis. Real GDP is projected to grow 3.8 percent and 3.6 percent in 2012 and 2013, respectively (International Monetary Fund, or IMF 2012). Despite this growth, poverty in the country remains high; with half of the population living below the national poverty line. The country is also highly heterogeneous, with large socioeconomic differences across states and across urban and rural areas. In 2010, while the extreme poverty ratio in the Federal District and the states of Colima and Nuevo Leon was below 3 percent, in Chiapas, Guerrero, and Oaxaca it was 25 percent or higher. These large regional differences are also found in other indicators of well-being, such as years of schooling, housing conditions, and access to social services. This case study assesses key features and achievements of the Social Protection System in Health (Sistema de Proteccion Social en Salud) in Mexico, and particularly of its main pillar, Popular Health Insurance (Seguro Popular, PHI). It analyzes the contribution of this policy to the establishment and implementation of universal health coverage in Mexico. In 2003, with the reform of the General Health Law, the PHI was institutionalized as a subsidized health insurance scheme open to the population not covered by the social security schemes. Today, the PHI covers all of its intended affiliates, about 52 million people