‘Traditional Birth Attendants’ and Reproductive Expertise in Postcolonial Mali

Over the twentieth century, Malian families turned to older women reproductive specialists like excisers (who initiated young women into adulthood), nuptial counsellors (who educated women for sex within marriage) and popular midwives. Their work reflected an expansive understanding of health and fertility. In the 1970s, Mali's government sought to incorporate ‘traditional medicine’ into the health system. State health workers trained popular midwives as ‘Traditional Birth Attendants’ (TBA). The same health workers defined nuptial counselling and excision as un-therapeutic and outdated cultural practices. Comparing these responses reveals the role of gender and social status in the making of an African health system.