Adopted in March 2024, the new Collective Agreement of Community Health Centers (CSCOMs) marks a turning point in the professionalization of Community Health Workers (CHWs) in Mali. The previous Agreement (2006) did not recognize CHWs as part of CSCOM staff.
Coumba Dicko, Muso-supported CHW, in the Yirimadio CSCOM courtyard.
With the adoption of this new Agreement, CHWs are more fully recognized as an integral part of the community health system in Mali. Article 1 of the Agreement recognizes them as salaried non-civil servant staff of Community Health Centers. This constitutes a significant step towards improving the working conditions of CHWs.
Several points have been revised in this new document, such as the classification of CHWs into two categories: category D (Matron/Caregiver), i.e. those with practical experience who will now receive a salary set at 75,000 FCFA or $122.35, and category B (Health Technician) who will receive a salary set at 105,000 FCFA or $170. Another important revision: considering instances of work-related accidents and illnesses, which was not the case previously.
It is important to recall that this new version of the Collective Agreement follows the April 2022 adoption of governmental decree N° 2022-0220/PT-RM, which is the first legal text that recognized the work of CHWs in the Malian health care system.
Muso's Technical Assistance team played a crucial role in the adoption process of this Agreement by providing technical and financial support to the National Federation of Community Health Associations of Mali (FENASCOM) for the recruitment of consultants, the organization of the validation workshop of the revised Collective Agreement of CSCOMs in Ségou in 2021, and many other activities integral to the adoption process. In addition, Muso's Technical Assistance team spearheaded and provided support for advocacy efforts with the pertinent governmental bodies.
Next Steps
Following the adoption of the Agreement, Muso will provide support in the adoption of complementary texts. Among these is a draft decree aimed at defining the conditions for the extension of CSCOM services with the primary objective being to ensure that CHWs fully benefit from the advantages stipulated in the Agreement.
This Agreement reflects the commitment of our government partners and the unwavering dedication of civil society to improve access to health care for populations. It represents a major step not only for CHWs and the communities they serve, but also for community health in Mali more broadly.
"The higher we aim, the more we will achieve. Access to health care for all must remain at the heart of our action, and every single one of us can make a difference to save a life," says Dr. Aïssata Maïga, Muso's Senior Manager for Health Systems Reform in Mali.
Muso remains committed to supporting our government partners to fulfill the promise of universal health coverage.