From embedded support to enduring systems change in Mali
In May 2025, we shared how Mali’s Sub-Directorate of Health Establishments and Regulation (SDESR) strengthened its community health system, building stronger leadership, clearer coordination, and a larger community health workforce over the course of Amp Health’s embedded support from June 2022 to May 2024. As the team transitioned into the Sustainability Phase in mid-2024 – where Amp Health offers ‘light touch’ support – a new chapter began, shaped by growing ownership, stronger systems, and the integration of long-term practices across the Ministry of Health.
The SDESR has continued to nurture a lasting culture of ownership and quality in health service delivery. This shift is not only reflected in how teams work together, but also in how national policies and priorities are being operationalised.
A key milestone in this phase has been the co-creation of Mali’s first national Quality Improvement (QI) training package, fully aligned with the country’s 2024–2028 National Strategic Plan for Improving the Quality of Health Care and Services. Designed collaboratively with the SDESR, the package provides practical tools, methods, and standards that help health workers identify challenges, test solutions, and strengthen the quality of care across all health facilities. For Mali, this marks a significant change. After years of relying on external consultants, the Ministry now has a nationally led, context-specific QI approach that is owned, understood, and driven by local teams.
The SDESR team has also played a central role in mobilising the resources needed to scale the programme. To date, more than US$200,000 has been secured, including support from the World Health Organization, enabling the development and rollout of the training package. This investment has supported strong early progress:
300 trainers have been trained across seven regions
By the end of 2025, the QI programme reached all 11 regions of Mali
By 2028, the Ministry aims to have trained 80% of the national health workforce in QI methods
These numbers reflect more than programme expansion. They signal increasing commitment to sustainable improvement, shared standards, and sector-wide alignment.
A system strengthened from within
This new phase builds directly on the foundations established during Amp Health’s embedded support: stronger leadership habits, clearer accountability structures, and a more coordinated approach to planning and decision-making. What is emerging now is a system that is not only functioning more effectively and continuously improving, but one that is also led by people who have the tools, confidence, and mandate to sustain change.
As the SDESR team advances through the Sustainability Phase, their momentum is evident. They are applying the skills strengthened in our partnership, expanding nationally led initiatives, and championing practices that reinforce collaboration and quality across the health system.