Integration of Traditional Medicine into the Management of Malnutrition in Mali: A Pilot Study in Bamako District
Abstract:
Childhood malnutrition remains a major public health challenge in Mali, where acute malnutrition affects nearly 9% of children under five, conventional treatment coverage remains low, and 70–80% of the population first seeks traditional medicine. This pilot study aimed to describe practices, perceptions, and interactions among traditional pediatric practitioners (TPPs), mothers, healthcare workers, and community leaders regarding childhood malnutrition in Bamako, and to identify factors enabling or hindering collaboration between traditional and conventional health systems. A descriptive qualitative study was conducted from February to April 2021 in three Bamako communes (II, IV, and V), combining semi-structured interviews and focus group discussions with 4 TPPs, staff from 3 community health centers (CHCs), and 13 community leaders, alongside anthropometric screening (mid-upper arm circumference, weight-for-height, and height-for-age) of 302 children aged 6–59 months attending traditional consultations. TPPs reported substantial daily attendance for common pediatric conditions, while malnutrition was rarely recognized by families or practitioners. Screening nevertheless identified 15.8% global acute malnutrition and 14.2% stunting. TPPs, mothers, and healthcare workers were generally receptive to strengthened collaboration, including MUAC training and bidirectional referral. Key barriers included the absence of formal referral pathways, divergent understandings of malnutrition, and limited feedback to TPPs. Involving TPPs in nutritional screening and awareness-raising appears feasible and could facilitate earlier detection among children who may otherwise remain outside the formal health system. Operational research with quantitative impact evaluation is warranted to confirm these findings.References:
[1]. Ministère de la Santé et de l’Hygiène
Publique du Mali. Plan d’Action Multisectoriel de Nutrition 2021–2025. Ministère de la Santé et de l’Hygiène
Publique, Mali; 2021. https://faolex.fao.org/docs/pdf/mli211666.pdf
[2].
Degefa K, Tadesse A, Ackley C,
Madrid L, Assefa N, Breines M, Sivalogan K, Maixenchs M, Blevins J. Using
traditional healers to treat child malnutrition: a qualitative study of
health-seeking behaviour in eastern Ethiopia. BMC Public Health. 2022;22(1):873.
https://doi.org/10.1186/s12889-022-13323-5
[3].
UNICEF. Treatment of wasting using
simplified approaches: a rapid evidence review. UNICEF, New York; 2020. https://www.unicef.org/media/97006/file/Simplified-Aproaches-Rapid-Evidence-Review.pdf
[4].
Heymsfield G, Radin E, Biotteau M,
Kangas S, Tausanovitch Z, Tesfai C, et al. Estimating program coverage in the
treatment of acute malnutrition using population-based cluster survey methods:
results from surveys in Burkina Faso, Chad, Democratic Republic of the Congo,
and Niger. Front Public Health. 2025;13:1513567. https://doi.org/10.3389/fpubh.2025.1513567
[5].
Dougnon OA, Charle-Cuéllar P, Toure F, Gado AG, Sanoussi
A, Lazoumar RH, et al. Impact of integration of severe
acute malnutrition treatment in primary health care provided by community
health workers in rural Niger. Nutrients. 2021;13(11):4067. https://doi.org/10.3390/nu13114067
[6]. Tattersall N. Mali’s traditional healers unlock herbal
cures. Reuters. 2006. https://www.reuters.com/article/world/malis-traditional-healers-unlock-herbal-cures-idUSL16899669/
[7].
Krah E, de Kruijf J, Ragno L.
Integrating traditional healers into the health care system: challenges and
opportunities in rural Northern Ghana. J Community Health. 2018;43(1):157-63. https://doi.org/10.1007/s10900-017-0398-4
[8].
Ikhoyameh M, Okete WE, Ogboye RM,
Owoyemi OK, Gbadebo OS. Integrating traditional medicine into the African
healthcare system post-Traditional Medicine Global Summit: challenges and
recommendations. Pan Afr Med J. 2024;47:146. https://doi.org/10.11604/pamj.2024.47.146.43011
[9].
World Health Organization Regional
Office for Africa. Guidelines for registration of traditional medicines in the
African Region. WHO Regional Office for Africa, Brazzaville; 2004. https://www.afro.who.int/publications/guidelines-registration-traditional-medicines-african-region
[10]. Ministère de la Santé et de l’Hygiène
Publique du Mali. Plan Décennal de Développement Sanitaire et Social (PDDSS)
2014–2023. Ministère de la Santé et de l’Hygiène Publique, Mali; 2014. https://extranet.who.int/countryplanningcycles/planning-cycle-files/mali-plan-decennal-de-developpement-sanitaire-et-social-2014-2023
[11]. Institut National de la Statistique.
4ème Recensement Général de la Population et de l’Habitat du Mali (RGPH 2009).
Ministère de l’Économie, des Finances et du Budget, Mali; 2009. https://www.instat-mali.org/fr/publications/recensement-general-de-la-population-et-de-lhabitat-rgph
[12].
World Population Review. Bamako
Population 2025. World Population Review; 2025. https://worldpopulationreview.com/cities/mali/bamako
[13].
UNICEF. Les enfants au Mali. UNICEF Mali; 2020. https://www.unicef.org/mali/les-enfants-au-mali
[14].
ONG ALIMA. Tout augmente, surtout la faim : l’urgence
alimentaire s’intensifie sur le continent africain. ALIMA; 2023. https://alima.ngo/communique/urgence-alimentaire-intensifie/
[15].
Chigangu C. Analyse des capacités des tradipraticiens et
des herboristes à intégrer la nutrition dans le paquet d’activités de la
médecine traditionnelle. Mémoire de Master 2; 2018–2019.
[16].
Balfe A. GOAL work with traditional
healers to tackle malnutrition in children in Niger. GOAL Global; 2019. https://www.goalglobal.org/stories/goal-work-with-traditional-healers-to-tackle-malnutrition-in-children-in-niger/
[17].
Menber Y, Belachew T, Fentahun N.
Diagnostic accuracy of MUAC for assessment of acute malnutrition among children
aged 6–59 months in Africa: systematic review and meta-analysis. Front Nutr.
2025;12:1536386. https://doi.org/10.3389/fnut.2025.1536386
[18].
Master R, Mguntha A, Baltzell K,
Bandawe G, Hooft A. Understanding the perspective of traditional healers on
their role within the Malawian healthcare system: a qualitative study in Thyolo
District. BMC Complement Med Ther. 2026;26(1):203. https://doi.org/10.1186/s12906-026-05387-2
[19].
Vissoh ACS, Klotoé JR, Fah L,
Agbodjento E, Koudokpon H, Togbe E, et al. Knowledge and practices of
traditional management of child malnutrition and associated pathologies in
Benin. J Ethnobiol Ethnomed. 2024;20(1):47. https://doi.org/10.1186/s13002-024-00684-x
[20].
Bachmann MO. Cost effectiveness of
community-based therapeutic care for children with severe acute malnutrition in
Zambia: decision tree model. Cost Eff Resour Alloc. 2009;7:2. https://doi.org/10.1186/1478-7547-7-2
[21].
World Health Organization. WHO
Traditional Medicine Strategy: 2014–2023. World Health Organization, Geneva;
2013. https://www.who.int/publications/i/item/9789241506096
