Denial of access to contraception in Mali

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Notes to broadcasters

Denial of resources and opportunities takes several forms. It generally refers to barriers imposed by the community that limit access to economic resources or livelihood opportunities, education, and, above all, health. In terms of reproductive health, denial of resources occurs when a person is prevented from using contraception, accessing health centres, fully exercising their sexuality, or when communities hold negative perceptions about allowing girls to choose their own husbands. It is important to recognize that this denial can take other forms as well, often keeping women and girls in situations of vulnerability.

A conservative society, in Mali as in many African countries, continues to uphold traditional practices. This environment remains conducive to barriers that hinder sexual and reproductive health, preventing this vulnerable group from thriving and benefiting from the many existing services. It is deeply rooted in patriarchy, where decision-making is often seen as the sole privilege of men.

Indeed, the concept of reproductive health faces numerous challenges, being under siege from rumors and misinformation that expose women to serious health risks (such as unintended or closely spaced pregnancies, induced abortions, etc.), thereby increasing their vulnerability. This occurs even though the Constitution of July 22, 2023, stipulates that “All Malians are born and live free and equal in their rights and duties. Any discrimination based on social origin, color, language, race, sex, religion, or political opinion is prohibited.” As a result, this topic continues to provoke intense debate.

While some understand and provide opportunities—or even help—women to learn about, understand, and access reproductive health services, even in rural areas, others remain steadfast in adhering to socially dictated ways of life and continue to be a significant obstacle. This persists despite the fact that women remain the main support in Malian families and dominate the informal sector, representing 66% of it, according to the World Bank.

For a better overall understanding of the topic, this radio segment speaks with three people. First, a lawyer who will explain the legal provisions on the subject. Next, a woman who has experienced denial of resources—being refused access to family planning due to social pressures—will share her testimony. Finally, we will speak with an official from the Directorate for the Promotion of Women, Children, and Families.

This radio script is based on real interviews. You can use it as a reference to conduct research and write a radio piece on a similar topic in your own region. Otherwise, you may choose actors to perform this script on your radio station. If you do so, be sure to inform your audience at the beginning of the program that the voices they will hear are those of actors and not the original interviewees.

For those wishing to produce programs on the challenges of reproductive health—particularly to study the community’s perception of women’s access to sexual and reproductive health services—it is recommended to conduct thorough research. This will allow a better understanding of the subject and help select qualified resource persons for interviews. Be sure to include the testimony of a survivor, interview a legal expert, and speak with an official from a service or non-governmental organization working on the topic. You may ask questions such as:

What is society’s perception of the denial of resources in relation to women’s access to sexual and reproductive health services?
What legal sanctions exist regarding this matter?
Which groups are most affected?
Who is responsible, and how can behavior change be achieved?

Length of program, including introduction and closing is about 25 minutes.

Script

HOST:

Hello and welcome to our program on the denial of resources or opportunities through the lens of sexual and reproductive health—a phenomenon rooted in traditional practices.

To discuss this, we are joined by three guests. Marama Sangaré, 33, mother of two daughters, has been a victim of this practice and continues to face its consequences. She will share her personal experience with us. Thiery Idrissa Goro, a lawyer by training and administrator at the Institut Kôrè des Arts et des Métiers in Mali, is also the UN Women focal point in Ségou and works on sexual and reproductive health issues at the community level. He will provide his expert analysis on the subject. Finally, Mamadou Bagayogo, program manager at the Regional Directorate for the Promotion of Women, Children, and Families, will discuss the support available for victims.

MUSIC INTRO FADES IN, THEN CROSSES OVER INTO THE SEGMENT

HOST:

Mr. Thiery Goro, thank you for giving us your time on air. To start, could you explain in simple terms what is meant by the denial of resources and opportunities?

GORO THIERRY IDRISSA:

Hello! Denial of resources occurs when someone is refused what they need to live or work with dignity—such as money, tools, land, education, and more. In other words, it also happens when someone is prevented from seizing opportunities to progress, like finding a job, and so on.

HOST:

So, how does this manifest in the context of sexual and reproductive health?

GORO THIERRY IDRISSA:

It is well known that we live in a traditional society where customary practices remain deeply rooted—a patriarchal society with an unequal power dynamic.

This situation is particularly fueled by rumors and misinformation about sexual and reproductive health, especially family planning for women.

Here, men mistakenly believe that contraception is a foreign tool designed to allow women not to have children, thereby threatening the family line; some even fear it could enable women to cheat on their husbands or allow young girls to engage in sexual activity without risk of pregnancy. Others think it is simply a way for women to avoid domestic work.

They perceive these methods as giving women a kind of power and freedom that allows them to escape male control, which they feel undermines their dignity and respect.

As a result, they are willing to use any means, taking advantage of women’s poverty to prevent them from accessing reproductive health services—such as family planning, pre- and postnatal care, post-abortion care, obstetric services, or even withholding money needed to pay for services. This is how the denial of resources or opportunities manifests in the area of reproductive health. In other words, any intentional obstruction of access to sexual and reproductive health services constitutes a silent but serious violation of the right to health, empowerment, and human dignity.

HOST:

Does this phenomenon exist in Mali, and who are usually its victims?

GORO THIERRY IDRISSA:

Yes, of course! This is common, especially in rural areas, though urban areas are not spared either. One of the main underlying causes is poverty, which is higher in rural areas than in urban ones. In 2023, Mali’s multidimensional poverty rate was estimated at 22.8%, compared with 33% in 2020. In most cases, men take advantage of this to maintain control over women, preventing them from thriving and managing their sexual health.

Another contributing factor is the low literacy rate among women. According to the fifth general population and housing census, in 2022, Mali had a literacy rate of 33.7% for people aged 15 and above. This rate was 30.9% in 2009, representing an increase of only 2.8 points. Across all regions, men are more literate than women.

The victims are generally girls and women, internally displaced children, and rural populations—especially those affected by inter- and intra-community conflicts.

HOST:

In your opinion, how does the community perceive this issue in Mali?

GORO THIERRY IDRISSA:

We live in a context where the denial of resources and opportunities is often seen as a structural injustice, fostering feelings of exclusion and even invisibility across many layers of Malian society.

Our society is complex and multidimensional, composed of many ethnic groups, each with its own way of life, customs, and traditions. Yet, a common—and regrettable—belief persists: that a woman must be submissive to her husband and should not take initiative, especially regarding her health and reproductive choices, which are considered the prerogative of men. Once married, a woman is often seen as the exclusive property of her husband, who decides on the number of children and the spacing of pregnancies, without concern for her overall well-being.

We truly need to change our behavior regarding these practices and view women differently. It is essential to understand that women also have a say in their health and must be able to assert their choices. Doing so will create a more harmonious living environment and ensure a better future.

Men and women should enjoy the same rights and opportunities without distinction. In fact, under Malian law, denying a woman access to quality reproductive health services is punishable.

HOST:

Exactly—what legal provisions exist on this matter?

GORO THIERRY IDRISSA:

In Mali, there are legal provisions addressing this issue. Notably, Law 02-044 on Sexual and Reproductive Health guarantees the right of all individuals and couples to access quality information and services related to sexual and reproductive health. However, there are limitations. Article 14 of the law states that “any adult may, with written consent, use an irreversible method of contraception.” Yet, for women in a couple, the husband’s consent is required. This requirement is problematic because, in most cases, husbands oppose the use of contraception, even when it may involve serious health risks for the woman.

Moreover, the Malian Constitution of the Fourth Republic (July 2023) includes principles of equality, non-discrimination, and fundamental rights, which can serve as a legal basis for seeking justice in such situations.

But the road ahead remains long on the legal front. Passing laws is not enough—they must be effectively enforced, taking societal realities into account, and offenders must be severely punished to protect the future of women.

HOST:

Thank you, Mr. Idrissa Thierry Goro. Now, we turn to Mrs. Marama Sangaré. You mentioned that you were a victim of a form of resource denial that ultimately disrupted your life. What consequences did you experience?

MARAMA SANGARÉ:

Indeed, I was a victim. I am my husband’s second wife. He is one of the village chief’s advisors and is known as a guardian of traditions. I am 34 years old and the mother of two daughters, both under two years old—closely spaced pregnancies. Weakened, I struggled to balance household chores with caring for the children. After several attempts to use family planning, my in-laws strongly opposed the idea and even threatened me.

A few months later, while preparing dinner, I began vomiting and felt dizzy. Suddenly, I fainted. After that, I found myself at the village community health center, where I learned that I was pregnant again.

Due to a lack of regular medical follow-up, I experienced severe complications during childbirth. Unfortunately, the baby was stillborn, and I developed a fistula.

That was the beginning of my ordeal. Here, men disapprove of contraception, relying on the village’s traditional norms, and go so far as to prevent women from accessing it under threat of divorce, stigmatization, or even forcing polygamy. If my husband had agreed, none of this suffering would have happened.

HOST:

Why didn’t you inform your relatives about your husband’s behavior?

MARAMA SANGARÉ:

I thought it wouldn’t change anything. You know, here they say a woman should never oppose her husband and must accept whatever he dislikes. This is also recommended by religion.

I already know my father’s position—he has never supported the idea of a woman going to the health center on her own or using contraceptive methods. He believes it encourages immorality and that other men will be around her. In the community, we are also told that a mother must be submissive to her husband, as the children’s future depends on it.

HOST:

How did your husband react after going through all of this?

MARAMA SANGARÉ:

Unfortunately, he doesn’t feel guilty at all and believes that this was God’s will. He thinks we were simply unlucky. In any case, unlike others who might abandon their wives, he has stayed. He supports me and gives me some money from time to time for my needs.

HOST:

At this moment, how do you feel, and what advice would you give to the women listening to us?

MARAMA SANGARÉ:

I am filled with regret and feel abandoned by my relatives. If I had received help to space my pregnancies and access the health center, none of this would have happened. I could have lived with dignity without experiencing all this suffering.

I advise women who are going through the same situation to not remain silent, to speak out, and to reach out to NGOs or other women’s rights services for support. Even if society reacts negatively, it is important to break the cycle. I also urge men to accept that their wives use family planning, to support them, and to ensure they have access to sexual and reproductive health services—for the well-being of the entire family.

HOST:

Thank you very much, Ami. We now turn to Mamadou Bagayoko, Head of the Women and Girls Division at the Regional Directorate for the Promotion of Women, Children, and Families in Ségou. What concrete actions does your service take in situations like this?

MAMADOU BAGAYOKO:

The Directorate for the Promotion of Women, Children, and Families works with several organizations to support the well-being of women, children, and girls. We promote family planning through community awareness sessions and oversee projects and programs on sexual and reproductive health as well as the fight against gender-based violence in the region.

HOST:

So, we should not prevent anyone from accessing reproductive health services, correct?

MAMADOU BAGAYOKO:

Absolutely! It’s important to clarify that the denial of resources related to access to sexual and reproductive health services does not only affect women or girls. Other vulnerable groups—such as people with disabilities or those from minority communities—can also find themselves in the same situation. They face enormous pressure, and out of fear, they remain silent, which increases their vulnerability.

To return to your question, no one should ever act as an obstacle to accessing reproductive health services.

However, society as it is currently structured contributes to the vulnerability of women and girls, primarily by making anything related to sexuality a taboo. It positions men as the ones in control of women’s bodies, their reproductive choices, and their overall well-being.

HOST:

So, how does this actually manifest at the community level?

MAMADOU BAGAYOKO:

In rural areas, men often refuse to give their wives money to access contraceptives. We frequently provide free services through outreach strategies, but even then, women often stay home, fearing reprisals at home.

At the same time, there is a serious problem with access to information, which is concerning for maternal and child health. We must take action to create an environment that supports the well-being and future of everyone.

HOST:

Earlier, you heard from Mrs. Aminata, who was a victim of a form of resource denial. What is your perspective on the community’s perception of this issue?

MAMADOU BAGAYOKO:

Her story highlights the main challenge we face. She is not alone—unfortunately, many women find themselves in this difficult situation but remain silent.

It reflects the attitude of the community: the persistence of harmful traditional practices, and the lack of support from community and religious leaders in promoting women’s rights and sexual and reproductive health rights.

Women are not simply subjects; they must have control over their own bodies. They have the right to information and to access reproductive health services, including family planning and STI care.

HOST:

So, what are the factors that contribute to this attitude in communities?

MAMADOU BAGAYOKO:

I would say gender inequality is a major factor. Here, social and cultural norms favor men, giving them a higher status than women and girls. In this patriarchal system, women have no decision-making power and must follow their husbands’ directives.

Added to this are the low levels of education among girls and the scarcity of resources—poverty often forces acceptance of anything. Furthermore, as is widely known, the security crisis that has affected the country since 2012 has weakened the humanitarian environment, disrupted basic social services, and caused populations to move to areas perceived as safer. All of this contributes to creating an environment that fosters such attitudes toward the most vulnerable groups.

Another very important point is the culture of silence. Many victims, out of fear of community judgment, accept the situation and remain in the shadows, exposing themselves to serious health risks, as in the case of Mrs. Sangaré. The perpetrators go unpunished, which, in turn, encourages such behavior.

HOST:

In cases of abuse or denial of access to information or reproductive health services, where can victims turn for help?

MAMADOU BAGAYOKO:

We receive victims at the directorate and refer them to holistic care centers, such as One Stop Centres, for treatment in cases of serious complications; to health centers; or to NGOs (such as ASDAP and AMPPF) for personalized counseling to better guide them and provide services.

If the case does not involve serious physical violence (rape, assault—which does happen), but the woman is hiding to use a method and risks punishment, we work with the family to raise awareness and try to resolve the issue.

HOST:

Thank you for all this information. So, what should we do?

MAMADOU BAGAYOKO:

We need to implement reforms to guide policies, ensuring the strict application and dissemination of the laws cited earlier by Mr. Goro at the policy level.

According to UNFPA, 27% of married women have a high unmet need for family planning—whether to space or limit births—despite strong demand, highlighting a major challenge in access to and use of reproductive health services.

We must continue community awareness efforts and equip young people, women, community leaders, and especially religious leaders to address the challenges posed by society.

HOST:

Dear listeners, we have reached the end of this program. Thank you for your attention and for listening. A special thanks to our guests. Let us remember that the denial of resources and opportunities in the context of reproductive health means refusing someone access to qualified sexual and reproductive health information or services. These violations are rooted in gender inequalities and unequal power dynamics that determine access to opportunities and resources.

In Mali, legal mechanisms exist to sanction anyone who engages in this practice. However, it is essential to strengthen community awareness and implement deterrent measures to promote genuine social behavior change. Despite numerous approaches already in place, such as the Community-Based Distribution (CBD) of contraceptives, unmet needs persist. Therefore, it is necessary to continue and intensify community awareness programs.

This program was produced with the participation of Mr. Idrissa Thierry Goro, a lawyer by training; Mr. Mamadou Bagayoko from the Directorate for the Promotion of Women, Children, and Families; and Mrs. Marama Sangaré, a woman who experienced denial of resources. Thank you all for your contributions. We look forward to joining you again next time. Until then, take care and stay well.

Acknowledgements

Contributed by: Dioro CISSE, Journalist, MALI (SÉGOU)

Reviewed by: Yeli Togola, Women’s Rights Specialist

Information sources

Interviews:

Goro Thierry Idrissa, lawyer by training and administrator at the Institut Kôrè des Arts et Métiers in Mali, interview date: January 16, 2026;

Mamadou Bagayoko, Program Manager at the Regional Directorate for the Promotion of Women, Children, and Families, interview date: December 10, 2026;

Aminata Diallo, a woman who experienced denial of resources, interview date: December 15, 2026.

This resource was produced through the “HÉRÈ – Women’s Well-Being in Mali” initiative, which aims to improve the sexual and reproductive health well-being of women and girls and to strengthen the prevention of and response to gender-based violence in Sikasso, Ségou, Mopti, and the district of Bamako in Mali. The project is implemented by the HÉRÈ – MSI Mali Consortium, in partnership with Farm Radio International (RRI) and Women in Law and Development in Africa (WiLDAF) with funding from Global Affairs Canada.

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