MALI: Sexual and Reproductive Health and Rights

Current situation

Mali

1. CURRENT SITUATION

HUMAN DEVELOPMENT INDICATORS

The UNDP’s 2010 Human Development Index (HDI) ranks Mali at the 160th position out of 169 countries, meaning that it is one of the most impoverished countries in the world. The data on the state of health and education for the population, particularly women, paint a pretty worrying picture.

 

SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS INDICATORS

 

FERTILITY RATE

The fertility rate in Mali has hardly changed over the last ten years: from 6.7 births per woman in 1996 (DHS 1995-96), the figure has dropped to 6.6 in 2006 (DHS 2006), 5.4 in urban areas and 7.2 in rural areas.

 

MATERNAL MORTALITY

Despite the improvement in prenatal care rates over the last decade, the high rate of maternal mortality practically rules out the possibility of Mali reaching Millennium Development Goal number 5 (MDG 5) by 2015. Although the HDS places maternal mortality at 464 for every 100,000 live births, according to various UN Agencies, the figure for 2008 was much higher, and stood at 830 for every 100,000 live births (WHO, UNICEF, UNFPA and World Bank, 2010). Despite the progress achieved, access to sexual and reproductive health services remain a problem for 63% of women, of which 53% are prevented from accessing such services due to economic reasons.

 

PREVALENCE OF CONTRACEPTION

Prevalence of contraception is very low, standing at just 6.3%. The modern method most often used is the pill (2.9%) and although the 2002 Reproductive Health Law guarantees the right to information and the use of contraception, 31.2% of women would like to reduce the number of children they have, or at least space them out more, but do not use any contraception method in order to do so.

 

EARLY MOTHERHOOD

 37.2% of women between 15 and 19 have been pregnant at least once.

 

EARLY MARRIAGE

Early marriage is another form of violence that has a negative impact on women, particularly on the sexual and reproductive health and rights of under-age women and girls, who are under huge pressure to start reproducing at an early age. Despite all the international agreements signed by Mali, the minimum age at which women can get married is 15, although younger girls can get married with their parents’ permission and special authorisation from the judge. This explains why, according to the 2006 DHS, 25% of young women between the ages of 20 and 24 got married at 15 or earlier and why this percentage has not changed over recent decades.

 

GENDER-BASED VIOLENCE

There are no data available on the number of women affected, but, as a number of surveys have shown, including the 2006 Demographic & Health Survey (DHS), violence against women is widely accepted among men and women, and 60% of women think that it is acceptable for a husband to be physically violent with his wife if she leaves the house without his permission or refuses to have sex with him. Female genital mutilation, moreover, continues to be a common practice across the country and according to the 2006 DHS, 85% of women have been mutilated, although there are large differences by region and ethnic groups. The figures stand at 80.9% in urban areas and 87.4% in rural areas.

 

UNSAFE ABORTION

28 out of every 1000 women between the ages of 15 and 44.

Mali maintains a very repressive legislation both in its Penal Code and its Reproductive Health Law, as it only permits therapeutic abortion when pregnancy jeopardises the mother’s life, if it has occurred as a result of rape or incest, and when the foetus suffers deformities that put its life at risk.

 

SEXUAL DISCRIMINATION

Same-sex relations are legal.

 

HIV/AIDS

Mali has a relatively low prevalence rate of HIV/AIDS (1.3%); it stands at 1.5% for women but for men it is around 1%. Although the data is not worrying, the population’s low level of knowledge on this subject is. Women are particularly ill-informed; in rural areas only 12.4% are aware of the problem, while 35.9% of women living in urban areas know about it (DHS 2006).

Instruments and policies

2. SRHR: INSTRUMENTS, MECHANISMS, LEGISLATION AND POLICIES

INTERNATIONAL AGREEMENTS SIGNED ON GENDER EQUALITY.

Moreover, Mali has ratified the main international and regional instruments regarding women’s rights in which women’s reproductive rights are guaranteed. Specifically, it has signed without reservations CEDAW, its optional protocol and the Protocol to the African Charter on Human and People’s Rights on women’s rights (Maputo Protocol), and the Solemn Declaration on Gender Equality in Africa. These instruments, according to Article 116 of the Constitution, take precedence over national laws.

 

NATIONAL LEGISLATION FRAMEWORK ON GENDER EQUALITY

Gender equality is recognised in the Constitution of Mali, approved in February 1992. Articles 1 to 21 lay down the same individual rights and liberties for all citizens, men and women, with no discrimination.

Over the last decade, notable positive changes have taken place regarding the legal recognition of women’s rights and thus, for example, the Government has passed regulations such as Law 02-044 of June 2002, on reproductive health, which consecrates the right to information, the right to risk-free motherhood and the right to information on and the use of contraception. Moreover, women’s organisations defended and worked hard to obtain the new Family Code that is favourable to women and the gender equality that Mali advocates in its Constitution and in the international instruments it has signed. The pressure of large sectors of society in Mai and its religious and political leaders prevented the Family Code from coming into force but at least the process revealed the strength and resistance of the women’s movement in the country.

As far as the penal Code is concerned, on the positive side we should underline the fact that it protects women from some kinds of violence, such as domestic violence (articles 207 and 226) although it neither recognises marital rape nor bans female genital mutilation, which makes Mali the only country in its region that does not penalize it.

 

POLICIES AND STRATEGIES IN GENDER EQUALITY, SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS

On a programmatic level, the first political references to gender issues in Mali were those made in the Action Plans for the Promotion of Women and the National Policy for the Promotion of Women 2002-2006. Recently, the 2009-2018 National Policy on Gender Equality between Women and Men (PNEFH, in its initials in French) has been passed, which should permit specific progress to be made in gender issues, both at a real and formal level, as well as the implementation of the commitments adopted by the country in the international arena.

In the field of health, the Health and Social Development Programme (2005-2011) is currently in force and there are framework documents on sexual and reproductive health such as the Sexual Reproductive Law of 2002, the 2007-2015 Road Map for the Acceleration of the Reduction of Maternal and New-born Mortality, the Policy on the Fight against HIV/AIDS or the National Plan, which defines national priorities and strategies on these questions.

It has not subscribed the Campaign for the Accelerated Reduction of Maternal Mortality (CARMMA)

We do not have data on the mechanisms for civil society participation in the definition of gender and SRHR policies.

Map of actors

3. MAP OF ACTORS

 

CIVIL SOCIETY EXAMPLES

As for the participation and contribution of women in Mali to the progress of women’s rights and sexual and reproductive health and rights, as we have mentioned above, it is thanks to them that steps forward have been made in this country. Since 1991, women’s organisations networks have multiplied, among which the following deserve a special mention: the Groupe Pivot Droits et Citoyenneté des Femmes, CAFO (Coordination des Associations et ONG Féminines) or the more recently set up FENACOF/MALI (Féderation National des Collectifs d’Organisations Féminines du Mali). Likewise, in the area of SRHR, there are also strong women’s networks, such as FemNet Mali and WILDAF Mali, which also bring together various dozens of women’s organisations and a health NGO network called Groupe Pivot Santé et Population.

Summary tables

MALI

HDI

160

FERTILITY RATE

6.6 children per woman

MATERNAL MORTALITY

464 deaths for every 100,000 live births

PREVALENCE OF CONTRACEPTION

6,3 %

EARLY MOTHERHOOD

37.2% of women between 15 and 19have been pregnant at least once

EARLY MARRIAGE

25% of young women between 20 and 24 got married at 15 or younger; this percentage has not changed over recent decades

GENDER-BASED VIOLENCE

60% of women agree that a husband can treat his wife violently in some cases

UNSAFE ABORTION

28 of every 1000 women between 15 and 44

SEXUAL DISCRIMINATION

Same sex relations are legal

HIV/AIDS

 

1.3%  total, 1.5% among women and 1% among men

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  

MALI

Human Development Index: 160

1.CURRENT SITUATION

2. INSTRUMENTS, MECHANISMS, LEGISLATION AND POLICIES

3. MAP OF ACTORS

Sexual and Reproductive Rights Indicators

International Gender Equality Instruments Ratified

National Legislation

Gender Equality and SRHR Policies and Strategies

CIVIL SOCIETY EXAMPLES in SRHR

- FERTILITY RATE: 6.6 births per women.

- MATERNAL MORTALITY: Although the 2006 HDS gives a figure of 464 for every 100,000 live births, WHO, UNICEF, UNFPA and the World Bank at 2010 give figures for 2008 of 830 deaths for every 100,000 live births.

- PREVALENCE OF CONTRACEPTION: 6,3%, 31.2% of women would like to reduce the number of children they have or space them out more but do not use any type of family planning in order to do so.

- EARLY MOTHERHOOD: 37.2% of women aged between 15 and 19 have been pregnant at least once.

- EARLY MARRIAGE: 25% of young women aged between 20 and 24 got married by the age of 15.

- GENDER-BASED VIOLENCE: 60% of women accept the use of violence by a husband if his wife leaves the house without his permission or refuses to have sex with him. According to the 2006 DHS, 85% of women have suffered genital mutilation, although considerable differences exist between regions and ethnic groups.

- UNSAFE ABORTION: 28 out of every 1000 women aged between 15 and 44.

- SEXUAL DISCRIMINATION: Same-sex relations are legal.

- HIV/AIDS: A relatively low prevalence (1.3%) although it is higher among women (1.5%) than men (just under 1%).

- CEDAW, and its optional protocol

- Protocol to the African Charter on Human and People’s Rights regarding women’s rights.

- Article 116 of the Constitution stipulates that these instruments take precedence over national laws.

 

- Gender equality is recognised by the Constitution

- Law 02-044 of June 2002 on Reproductive Health

- In terms of the Penal Code, a positive aspect relates to the protection it offers to women from some types of violence such as domestic violence or rape (articles 207 and 226) although it does not recognise marital rape or ban female genital mutilation, which makes Mali the only country in the region not to penalise it.

 

 

 

- Action Plans for the Promotion of Women

- 2002-2006 National Policy for the Promotion of Women.

- 2009-2018 National Policy on Gender Equality (PNEFH, in French),

- 2005-2011 Health and Social Development Programme,

- 2007-2015 Road Map for the Acceleration of the Reduction of maternal and new-born mortality,

- Policy on the Rights against HIV/AIDS.

- 2007 National policy to abandon the practice of genital cutting and National Action Plan.

- Groupe Pivot Droits et Citoyenneté des Femmes

- CAFO (Coordination des Associations et ONG Féminines)

- FENACOF/MALI (Fédération National des Collectifs d’Organisations Féminines du Mali)

- AMSOPT, APDF, ASDAP…

- In SRHR, women’s networks:

- FemNet Mali and WILDAF Mali and the NGO health network called Groupe Pivot Santé et Population

 

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Mali

 

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