Mali’s constitution guarantees the right to health. The objective is to have health for all in the nearest future possible.

In 1991 Mali developed a healthcare policy based on community involvement, cost recovery and the availability of essential medicines.

Health policy in Mali is developed by the Ministère de la Santé (Ministry of Health) and implemented by the Direction Nationale de la Santé (National Health Directorate, DNS).

The total health budget in 2003 for Mali was CFA 42,566,216,000 (64,788,761ドル).[2] The majority of this budget is financed by multi and bi lateral donors.

National policies and plans are elaborated centrally in Bamako and it is the responsibility of each region to adapt these to its local needs. Mali is currently putting a large emphasis on decentralisation and therefore the Regional Health Directorates (DRS) are playing a larger role in the development of regional health programmes.

Decentralisation is also impacting the three National Hospitals (Point G, Gabriel Touré and Kati) as they are all being given a larger role in management and decision making with less and less intervention from the central level.

The same is true for the 7 Regional Hospitals. Below the Hospitals are the Centre de Santé de Centre de Santé de Référence (CSREF, Referral Health Centre). These facilities are linked to the DRS and are present in each Cercle (Circle, literal translation, equivalent to a District). These facilities are health centres with in some cases quite advanced facilities. Their role is to act as a link between the Centre de Santé Communautaire (CSCOM, Community Health Centre) and the Hospitals. Each CSREF has a few CSCOM reporting to it. The head of the CSREF has a supervisory role over the CSCOM in his Cercle.

Most CSCOM are run by an Association de Santé Communautaire (Community Health Association, ASACO). They provide basic preventative and curative services in maternal and child health.

At each level of the health system cost recovery is put in place for consultations and also for medicines and any other supplies used in their treatment. People can become members of ASACOs and pay a yearly membership fee and then have a reduced consultation fee. In theory when patients are referred to a higher level of the health system their consultation fee is waived.

In Mali there is a large discrepancy between the human resources available in Bamako versus the rest of the country. [3] In Bamako there are a total of 4,030 healthcare workers versus only 3,279 for the remainder of the country. This variation in access to healthcare is also shown in the difference with regards to the number of CSCOM and CSREF people have access to in different areas.
In looking at this information 3 other factors should be noted:

• Distances and accessibility are not the same in each of the areas
• Availability of private health clinics is greater in urban areas, especially Bamako
• Quality of care and personnel available varies greatly between each region