Publication: Cultural Resources and Maternal Health in Mali
Loading...
Published
1999-09
ISSN
Date
2012-08-13
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.”
Digital Object Identifier
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 Digital Africa(Washington, DC: World Bank, 2023-03-13)All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.Publication FY 2025 China Country Opinion Survey Report(Washington, DC: World Bank, 2025-08-04)The Country Opinion Survey in China assists the World Bank Group (WBG) in better understanding how stakeholders in China perceive the WBG. It provides the WBG with systematic feedback from national and local governments, multilateral/bilateral agencies, media, academia, the private sector, and civil society in China on 1) their views regarding the general environment in China; 2) their overall attitudes toward the WBG in China; 3) overall impressions of the WBG’s effectiveness and results, knowledge work and activities, and communication and information sharing in China; and 4) their perceptions of the WBG’s future role in China.Publication The World Bank Group in Georgia, 2014-23(Washington, DC: World Bank, 2025-07-30)This Country Program Evaluation assesses the performance and effectiveness of the World Bank Group’s support to Georgia in achieving the country’s development objectives. In the decade leading up to the evaluation period, Georgia pursued economic reforms to attract critical investments for becoming a regional trade and transport hub. Ambitious economic reforms went hand in hand with efforts to improve human development and strengthening social protection systems. Growing geopolitical tensions and internal political polarization have challenged Georgia’s reform progress in recent years. The Bank Group’s strategy adapted well to Georgia’s development needs and was well coordinated with other development partners. It successfully employed a range of instruments to help increase competitiveness, growth, and job creation, and effectively contributed to improved infrastructure and increased trade by using programmatic and innovative approaches. The Bank Group’s regular investments in analytical work and the switch to results-based programmatic support helped improve the efficiency and effectiveness of education and health care systems. The IEG offers the following lessons based on the evidence and analysis in the Country Program Evaluation: (i) Prioritizing Bank Group support around the move towards deeper regional integration was an effective anchor for key economic reforms for economic convergence. (ii) Pursuing a selective and adaptive approach in a country with high implementation capacity and institutions, strong coordination among development partners, and access to a wide range of external resources can allow the Bank Group to exercise significant influence in areas of comparative advantage and global expertise. (iii) A stronger focus on outcome-based programmatic approaches helped to build local capacity and crowd-in partner financing.Publication FY 2024 Seychelles Country Opinion Survey Report(Washington, DC: World Bank, 2025-01-27)The Country Opinion Survey in Seychelles assists the World Bank Group (WBG) in better understanding how stakeholders in Seychelles perceive the WBG. It provides the WBG with systematic feedback from national and local governments, multilateral and bilateral agencies, media, academia, the private sector, and civil society in Seychelles on: (1) their views regarding the general environment in Seychelles; (2) their overall attitudes toward the WBG in Seychelles; (3) overall impressions of the WBG’s effectiveness and results, knowledge work and activities, and communication and information sharing in Seychelles; and (4) their perceptions of the WBG’s future role in Seychelles.Publication The World Bank Group in Tanzania, Fiscal Years 2012–22(Washington, DC: World Bank, 2025-07-22)This evaluation assesses the relevance and effectiveness of the World Bank Group's support to Tanzania between Fiscal Years 2012 and 2022. Over the past decade, Tanzania has experienced resilient growth, with an average annual per capita GDP increase of 2.2%. However, poverty remains widespread and slow to decline, underscoring the need for more inclusive growth. The report examines the Bank Group's strategic and operational approaches during this period, which were aligned with Tanzania's development priorities and focused on industrialization, human development, and public sector reforms. The evaluation includes thematic chapters on the Bank Group's support for private sector-led growth and spatial transformation, as well as lessons to inform future support to the country.