Mali Health Organizing Project Health Savings Program Supporting
Transcription
Mali Health Organizing Project Health Savings Program Supporting
In This Report INTRODUCTION Letter from the Executive Director Our Vision and Values Programs and IMPACT Action For Health Health Savings Health Radio Clinic & Maternity Advancing the Story OUR MISSION: 1 2 3 4 5 6 7 FINANCE and LEADERSHIP Finances Staff & Board Partners & Supporters CONTACT Mali Health Organizing Project PO Box 426081 Cambridge, MA 02142 www.malihealth.org info@malihealth.org 8 11 12 Mali Health’s mission is to reduce maternal and child mortality in resource-poor communities in West Africa. To achieve this, Mali Health implements replicable programs that improve access to quality primary care at low costs, while increasing the capacity of and participation in local health systems. Dear Friends & Colleagues Mali Health’s sixth full year has been a successful one, thanks to ongoing support at all levels. In 2013, our programs reached more people than ever before, as we began expanding our geographic footprint. We launched a renewed strategy, realigning with the evolving needs of the communities we serve and informed both by our successes and by the challenges of the past several years. Most importantly, we identified those areas where we can make the greatest impact in the lives of others. We’re targeting programs that can have an impact at each stage of the healthcare delivery process – from health financing for women to community education initiatives to improving the training of staff and quality of service at local clinics. We’re putting additional efforts into efficient operations and transparency. We’re investing in local staff capacity, ensuring our small workforce on the ground is an exemplar of possibility. One success is our new Health Savings program, where collectives of women save money into small village banking accounts, assuring access for financing both economic activity and health expenses (p. 4). Another success is the reduction in per-visit costs for those children enrolled in our program (p. 3). By contracting with medical management teams, standardizing treatments, and providing training for staff, the average clinical cost has been reduced 25%, from $12.51 to $9.47. The average medical costs per month per child enrolled in the program also decreased by one third. Our achievements last year were set against an evolving backdrop of war and peace. Rebels threated the capital city, an international military response intervened, and democracy was eventually restored, giving hope for a brighter future in Mali. Despite the turbulence of the last two years our budget and revenue have both grown by 40% (p. 10). Mali Health remains in a strong position as a service provider and as an innovator in the field of global health and development. As we expand our reach and impact, what gives me the most confidence is the progress I see in our organization every day. From working with our dedicated team on the ground, communicating with our passionate supporters around the world, or watching our model make a difference in the lives of so many, I can see our mission in action and our role in facing the greater challenges in maternal and child health. Our best days and deepest impact remain ahead of us. Thank you, Kris Ansin, Executive Director PS - In 2014 we have begun distributing monthly program reports - sign up here. You can also sign up for our newsletter and visit our blog. If you have more questions about our work, how funds are used, or have suggestions, I invite you to contact us directly at info@malihealth.org. 1 OUR VISION & VALUES We envision a world where health systems can meet the basic needs of the poor and eliminate preventable death, effectively treat disease and enhance self-efficacy and dignity for mothers and children. For six years, Mali Health has worked with communities on the outskirts of Bamako to improve health outcomes for women and children through a partnership with residents, local staff, government officials and grassroots donors. Our track record of cost-effective results through community-driven, culturally appropriate, and sustainable approaches serves as an effective development model for other communities. As we prepare to expand our reach in 2014, we remain committed to our core values: î We work to overcome barriers in the workplace, in the field, and in the cultural and political landscapes, achieving success through unremitting dedication. î We invest in local resource development, particularly among our staff and field workers. î We hold ourselves accountable for measurable results, including financial performance. î We leverage innovation, addressing existing causes of poor health through new frameworks. î We empower the poor, particularly women, as a catalyst and complement for lasting change. î We concentrate on supporting marginalized populations, expanding the zones of social and financial inclusion. Meet Mariam Programs Director Mariam Fofana Diallo joined Mali Health’s staff in July of 2013, bringing her wealth of experience from international NGOs and government organizations throughout West Africa to lead our programs in their next stage of growth. Though Mariam has worked for many projects, she feels that Mali Health’s cause is particularly near to her heart: “To be part of this team that is working tirelessly, and in conditions that are never ideal, to do what is vital: saving lives, providing dignity and empowerment, and giving hope to people forgotten by the health system.” Read more of Mariam’s story here. 2 ACTION FOR HEALTH Focused on the poorest residents in one of the poorest communities in Bamako, Action for Health is working to change health attitudes, behaviors, and outcomes at the community level. 1,858 children covered 900 mothers receiving prenatal care The most vulnerable families in the community receive lifesaving, basic healthcare for pregnant women and children under 5 – those most at risk of dying from common and preventable diseases like malaria, diarrhea, respiratory infections, and malnutrition. Community health workers make regular visits to enrolled families, checking on the vitals of children and expecting women and providing health education on disease prevention and early care seeking. These community health workers serve as a vital bridge between the most disadvantaged citizens and the national health system, providing a link to the most vulnerable and marginalized. However, Action for Health provides families with more than health services and care – it helps to preserve the dignity of recipients. Enrollees are active participants in their health and the health of their families. Mali Health provides support where needed, but helps empower families to take charge of their own health care. The result – families who may before have felt powerless in the face of illness proudly watch as their children develop into healthy, thriving future leaders of their community. “Without Mali Health, I don’t think my second child would have celebrated her 2nd birthday. She had chronic malaria and fell sick often. But each time she got sick, Mali Health took care of her.” Ouleymatou Koné, mother of three 30,421 home visits 57% increase from 2012 30 hrs between onset and treatment $9.47 Per clinic visit Down 24% from $12.51 in 2012 99.5% survival rate compared to 87% nationally 3 HEALTH SAVINGS Through Health Savings, women build the financial independence and savvy they need not only to support their families, and gain the power and resources to change their communities for the better. Health Savings seeks to improve Mali Health’s sustainability by empowering families to provide for their own health costs through an innovative group savings plan. When the pilot program in closed it’s first cycle in 2013, participants and those wishing to participate asked that a second round begin immediately. Mali Health is pleased to count Health Savings as our newest full program. “Participation in this group has truly served me well. I have access to funds to develop my business and I have less pressure while in charge of my family because I know that in case of illness I can at least access first aid. The group has also helped to foster agreement between us women, which allows us to unite for a common cause.” - Assan Tapily, Savings for Health participant The women in Mali Health’s Health Savings groups come together come together weekly to learn about preventive health care and financial management. These women also deposit small amounts of money into two collective accounts. In the first, members draw loans to support revenue-generating activities, such as starting a small business. From the second, women access no-interest loans in order to cover health costs at the local clinic. At the end of a cycle, women are returned their savings, along with the dividend through interest earned, and encouraged to make good on initial commitments to allocate savings to preventive health products. 133 women saving in 6 groups 50 loans taken out, 13 to directly finance healthcare 100% of loans repaid Over the course of the first cycle, group members learned not only about managing their money, but also about the importance of seeking early treatment for their illnesses, how to recognize danger signs in children, and what a woman can do to ensure she has a healthy pregnancy. 4 HEALTH RADIO Mali Health’s Radio Program and it’s related listener groups serve not only to disseminate health education to the larger community, but to create awareness of health issues facing disenfranchised communities and to spark dialogue and action. Communication is at the core of Mali Health’s work in the community and health radio is a vital tool to reach residents and families on a large scale. This year, in partnership with Oxfam Great Britain’s Health Policy Action Fund, we reached community members on a wide range of health issues including the prevention, symptoms, and treatment of diseases like malaria, diarrhea, respiratory infections and typhoid fever. We also focused on the structure and functioning of the health system in Mali and how citizens can make their voices heard in their local community health clinics. Finally, we were able to respond to the crisis in Mali, by branching out and discussing the responsibilities and rights of citizens in a democracy, especially as it pertains to health. “We have really begun to understand a lot of health issues and interventions that, before, we were just unaware of or didn’t think about. Even looking around our courtyard I can see the difference Sigida Joli [Mali Health’s radio show] has made for us – everything is clean and ordered now because we know that sanitation is an important way to prevent diseases like malaria and respiratory disease.” - Kadia Traoré, local woman and Mali Health radio listener After launching a discussion of the health system among it’s listener groups, Mali Health’s reached out to three local women’s groups and this collaboration led to a report detailing a road map to improve the healthcare system for the commune as a whole. On November 14th, a public forum hosted by Mali Health present the report to 18 health organizations, including several government agencies. As Public Affairs Manager and long time Mali Health employee Adama Kouyate said, the forum served, “to give a voice to the poor and to launch discussions about barriers to universal access to health services, something that is not addressed as often as it should be.” 104 shows broadcast on Bamako’s most popular station 415 listener group participants 3,500+ listeners 190% Increase in health topic knowledge following a show 5 CLINIC & MATERNITY Built in 2010 by Mali Health in partnership with local officials and community members, the Sikoro clinic has become a focal point of health advocacy and education in the community. We’re committed to making it a model for equal access to health. Mali Health emphasizes access to care as a vital component of empowering community members to take charge of their own health. We continue to work in an advisory role to the clinic, providing oversight and training to improve service and lower costs, thus addressing the substantial barriers preventing the poor from seeking early, potentially life-saving care. In August, the clinic reached a new milestone: a dedicated maternity ward opened it’s doors to a community that had identified this need in a public meeting just 10 months prior. It was a joint effort - with One Day’s Wages and Mali Health’s network of committed donors providing funding alongside a successful local drive and with equipment provided by the government health system and the Malian Red Cross. Clinic births have increased nearly 300% in over the past three years and the dedicated maternity ward provides a space, not just for private, sanitary birth conditions in the presence of a skilled attendant, but for vital pre- and post-natal care and family planning services. The impact couldn’t be clearer: the clinic received nearly 8,000 visits this year, our highest count ever. More women attended their recommended visits than ever before and more children were born healthy, properly nourished and with a greater chance of survival. Increased access: clinic visits on the rise “As a woman, this maternity ward warms my heart and makes me even more proud to work here at the clinic.” - Ms. Adam Traoré, Head Nurse Clinic visits per year 8,000 7,899 clinic visits up 286% from 2010 $8.22 Avg Rx Cost Down 30% from $10.70 in January 588 vaccinations for common childhood diseases 449 prenatal visits 6,500 5,000 3,500 2010 530 2011 2012 2013 babies delivered 6 ADVANCING THE STORY Mali Health prioritizes strategic programming, targeting the areas where we can have the greatest impact, and continually assessing our progress toward concrete goals. In 2014, we will set out to achieve more than ever before, we will: o Expand our Health Savings Initiative o o Move program services into two new peri-urban communities o Increase our use of evidence-based programming, with full reports in 2014 on Action for Health (with Brown University and Innovations for Poverty Action), clinical improvements, and health savings o Widen our range of training workshops for clinical teams, including rational prescription, obstetrics care, and Kaizen quality improvement o Develop and support local advocacy and organizing campaigns to increase participation in and access to the public health system Here’s how we measured up against last year’s benchmarks: þ Construct a maternity ward and basic laboratory to support the growing populations of Sikoro and Sourakabougou þ Support 2,000 children under 5, their mothers, and their families through Action for Health’s program expansion, launched at the end of 2012* þ Collect and share year-1 results of an external randomized control evaluation with Brown University and Innovations for Poverty Action on the effectiveness and efficacy of our model of health care delivery þ Pilot innovative financing schemes, including the launch of a Health Savings finance initiative and rational prescription contracts to help families save for health care costs and control against health shocks þ Expand our Action Training services and Radio Listener Groups to reach additional populations Develop a family planning initiative *1,886 children enrolled in Action for Health as of December 31, 2013 7 FINANCES Expenses Detail In 2013, Mali Health generated nearly $345,000 in revenue, a 14% increase – or $42,000 – compared to revenue accumulated in 2012. This growth can be attributed to an increase in number and size of grants awarded compared to previous years, as well as a low donor attrition rate. Our overhead remained consistent with previous years – 83% of all funds directly supported program activities, while the remainder of funds were divided among administrative, development, and management activities both in Mali and in the US. We ended our year with just over $297,000 in expenses, creating a surplus of almost $48,000. These expenditures supported Mali Health programming and expenses for nearly 2,000 children under 5, financed the construction of a maternity ward, and launched new programs in health financing and quality improvement, among several other activities. As a result of yearlong strategic planning efforts, our Action Training program was closed and relevant activities were incorporated in other programs, and our Radio Program was folded into a larger Department of Communications. In 2014, Mali Health intends to maintain a balanced financial scorecard, soliciting revenue from our grassroots network, major gifts, and institutional awards. Thank you for your ongoing commitment as the organization continues to grow, achieving greater reach and impact through our community driven models. We aim to maintain the highest levels of both transparency and impact. We remain grateful for every dollar received, and remain honored to serve in the role we do with the ongoing support of so many. Management & General 6.5% Fundraising 10.2% Program Services 83.3% Revenue by Source Foundations & Corporations 40.5% Gifts in-kind, interest & other income - 0.8% Individuals & Family Foundations 58.7% 8 FINANCES Statement of Financial Position Statement of Activities FY2013 FY2012 FY2011 $142,471 $189,324 $87,184 $75,172 $75,000 $51,037 Accounts Receivable $128,564 $49,462 $57,612 Undeposited Funds $16,131 $5,225 (unaudited) Assets Cash and Cash equivalents Savings Employee Cash Advances or Loans Security Deposit Total $300 $364,468 $4,543 Subcontractor Holding Account $737 $5,280 $319,011 FY2013 FY2012 FY2011 Revenue Individual and family foundations and Foundations and corporations Support $202,530 $174,632 $156,689 $139,571 $120,411 $93,164 $2,826 $10,331 $572 Total Public Revenue and Support $344,928 $305,374 $250,425 $247,515 $151,782 $142,137 Management $16,230 $11,477 $10,363 Fundraising $19,284 $10,672 $7,799 Administration $14,110 $11,468 $4,941 $297,139 $185,399 $165,240 $47,789 $119,976 $85,213 $311,400 $195,833 $112,225 $359,189 $315,809 $203,264 (audited) $1,830 Liabilities Liabilities and Accounts payable and accrued Net Assets expenses Total Liabilities (audited) $195,833 $3,203 (unaudited) Gifts in-kind, interest, and other income Expenses Program services Total Expenses and Losses Net Assets, beginning of Year Net Assets Temporarily restricted Total net assets Total Liabilities and Net Assets (audited) $3,203 Increase in Net Assets Unrestricted: Undesignated (audited) $24,897 $238,386 $189,336 $139,571 $80,624 $6,497 $359,188 $315,807 $195,833 $364,468 $319,011 $195,833 Net Assets, end of year 9 FINANCES Statement Cash Flows FY2013 FY2012 FY2011 $342,101 $299,841 $246,386 $2,826 $3,149 $955 $344,928 $302,990 $247,341 $247,515 $152,221 $142,136 Management and General $30,340 $23,369 $18,163 Fundraising $19,284 $11,833 $4,941 $0 $0 $0 Total supporting services $49,624 $35,202 $23,104 Total expenses $297,139 $187,423 $165,240 $47,789 $115,567 $82,101 Net Assets, Beginning of year $311,400 $195,833 $113,732 Net Assets, End of year $359,189 $311,400 $195,833 (unaudited) Support Received from Donors and Grantors and Other Revenue Total Support and Revenue Expenses Program Services (audited) (audited) Supporting Services In kind expenses Net Assets Increase in Net Assets 10 OUR STAFF Kris Ansin, Executive Director Mariam Fofana Diallo, Programs Director Devon Golaszewski, Outgoing Programs Director Diakaridia Traoré, Medical Advisor Adama Kouyate, Communications and Public Affairs Manager Djibril Traoré, Health Worker Coordinator Dramane Diarra, Action Training Coordinator Baba Bayoko, Project Izumi Coordinator Matthew Schinske, Outgoing Operations Coordinator Danielle Hull, Monitoring and Evaluation Coordinator Oumar Coulibaly, Accountant and Bookkeeper Kadiatou Savane, Radio Announcer Abdoul Toure, Radio Announcer Moutaph Togolo, Radio Announcer Aissata Touré, Radio Assistant Mariam Sissoko, Health Savings Assistant Lauren Veverka, Operations Manager Stephen Muse, Communications Manager STAFF & BOARD INTERNS & VOLUNTEERS Board of Directors Joseph Camardo, MD, Chair Maureen Caulfield, MD, Vice Chair Nathan Duckles, Treasurer Erin Kitchell, Secretary Kris Ansin Christopher Bull, PhD Caitlin Cohen Marie-Claude Tanny Jason Lee George Lehner Marc Mitchell, MD, MBA Mamadou Niang Joshua Spry Jerry Zeldis, MD, PhD MALI ADVISORY BOARD Ben Aboubacar, MD Sidiki Coulibaly Yaye Danfakha, MD Abdoul Diallo Alpha Zancoura Doumbia Mamadou Niaré Saloum Soumaré Boubakar Traore, MD Mary Magdalene Togo, MD Hannah Deegan Amelia Angevine Leah Kazar Christine Le Lindsay Newton Laurie Ohlstein Isabel Pett Brown University Student Group COMMUNITY HEALTH WORKERS Mariam Ballo ▪ Oumou Camara ▪ Mariam Cisse ▪ Sokone Coulibaly ▪ Kadia Dembele ▪ Sidi Fane ▪ Fanta Goita ▪ Aminata Keita ▪ Agaichou Maiga ▪ Mariam Samassekou ▪ Kadiatou Savané ▪ Sanata Sissoko ▪ Moustapha Togola ▪ Oumou Togola ▪ Gauanse Traore ▪ Malick Yalcoue ▪ Francis Baya ▪ Hawa Diarra ▪ Mariam Traore IZUMI: Christine Soucko ▪ Ramata Traore ▪ Aminata Diarra ▪ Fatoumata Founé ▪ Coulibaly ▪ Adama Iro 11 OUR SUPPORTERS William Smith Joshua Spry Jim Stork Ann Strauss Marie-Claude Tanny Supporters: $100-$499 Corporations and Foundations Leaders: $2,000-$4,999 Adopt a Doctor Child Health Foundation Conservation, Food and Health Healthcare Business Women Association of Canada International Foundation International Institute for Communication and Development Izumi Foundation Fortress Investment Group Girls Rights Project Merck Partnership For Giving One Day’s Wages Oxfam Great Britain Health Policy Action Fund Pew Charitabe Trusts Pfizer Matching Gifts Program Rinet Company Rotary International Foundation Smith S.H.A.R.E. Foundation Betsey Ansin Cherie Ansin and Costas Malapanis Ken Ansin George Lehner and Diana Day Helen Ryan Karl Schmidt Sustainers: Monthly Donors Souleymane Konate Julia Scarborough Helen Lindley Kathleen Franklin Lindsay Clarke Jumay Chu David Miller Ross Borden Denise Pearce Helen Smith Vistionaries: $5,000 and up Ron Ansin Isma and Cherif Benattia Joseph and Linda Camardo Michael and Maureen Caulfield Tournelles Foundation Nathan Duckles Antoine and Emily Van Agtmael Jerry Zeldis Partners: $1,000-$1,999 Kristopher Ansin Kym Craven and Rick Bailey Erica Baird Sunita Sheth and David Bayard Tess Borden Christopher Bull Lucian Cohen Bonita Falkner and Susan Shively Jane and John Isaac Eric Knight Anne-Marie and Bill Nichols Christie Paul Harold Marder and Jewel Slesnick Mary Slocum Lawrence Stein Matt Steinberg Joel and Jan Wierenga Michael Zucker Sponsors: $500-$999 Christopher Barajas Yulii Bogatyrenko The Borden Family Mark Borden Gilbert Casellas Alan and Bari Harlam Kathleen Hull Wes Wolf and Katie Hunt Louis Kayitalire Erin Kitchell Andrew Morris Joseph and Virginia Obrien John and Sheila Peyton Nancy Quinn Kathleen and Robert Siwicki Elizabeth Aeschlimann All Saints Episcopal Church Liesa and Milton Allen Jonathan Altshuler Andrew Baca Kristen Balash Laura Bellerose Jack Bertges Erica Besso Sophia Bogdasarian Emma Borden Linda Borden Lindsay Borden Laurel Bradley Jacqueline Brook Ed Buke Christopher Burke The Sitemaker Site Donna Camardo Charles Carr Julan Chu Kent Chu Philip Chu Catherine Clodfelter Caitlin Cohen Loretta Cohen Peter Connolly Michael Conway Michael Cox Jim Craven Neal Fenwick and Christina Dann-Fenwick Trisha Deegan Lisbeth Shepherd and Kevin DeLaney Jacob Digregorio Tamara Ducey George Duncan Lisa Durkee David Egilman Ernest Cisse Gerardo Escalera Alyson Faller Joseph Findaro Paul Rosenblum and Eileen Fitzgerald Kenneth Foon Vida Foubister Jean Freedman and Jonathan Pollock Christoph Frevel Maureen Friar David Summers and Linda Golaszewski Devon Golaszewski Stephen Goldfinger Gene Miller and Jenny HackforthJones Christopher Hamblett Brett Hardy Donna Higgins John House Donald and Lynn Janklow Robert Jensen Elizabeth Kast Dede Ketover Glenn Kitchell Holly Kortright The Kraft Family Adaline Kumar Braden Kuo Jason Lee Charles Lindamood Amy Lippincott Jacob Lipton John And Donna Looze Judith Lorimer Brian and Deanna Lurvey Peter M Abrahamsen Bernadette Maida Peter and Carol Mailloux Yai-Yai And Papou Malapanis Lorene Marini Debra Marshall Tad McGeer Liz Mcgehee Mary Mcmahon William Mees Shelby and Henry Miller Deborah Mills-Scofield Marc Mitchell Douglas Ruby and Mary Beth Moore Jeni Morrison Alice Nadin Diane Nardone Mamadou Niang Matt Nugent Barbara J O’Connor Amber Oberc Kathleen O’brien Ellen Oconnor Mr. and Mrs. Leonard Orzechowski Suzanne and Ronald Pancrazi Christopher Percopo Randy Perillo Sharon Pfeiffer Jon Pisarski Robin Reid and Hugh Poland Li Qi Jesse Reising Fritz Reuter Brian Rivotto Anne Roberts Walter 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Brennan Angela Brisbane Emily Briscoe Joshua Brown Ronald Brown Maria Bruge Nadege Bryan Djibril Camara Cecilia Camardo Greg Cameron Clare Campbell Tara Carloni Abigail Carpenter Carlo Carroccia Annie Carter Vanessa Carter Deborah Cary Charles Casler Paul Cathey Matthew Caulfield Sarah and Peter Chatel Nancy Church Regi Clarence Justin Clark Tim Cleary Emma Clippinger Brian Cohen David Cohen Gary Cohen Jay Cohen Lee Cohen Ilana Cohn Stephanie Cole Brittany Collins Melinda Cook Nicholas Coolidge Terrence Corgan Helen Corrigan Dorothy Craven Forth Christine Cutting Aubrey Cyphert Bradford Dahms Susan and Christiane Dahms Nanshelmun Dashan Aaron Davis Kathleen Davis Kathryn Davis Hannah Deegan Endrit Demi Ivi Demi Judith Mohns and Francois Deschamps Thierno Diallo Steve Diamond Dana Diarra Pia Digirolamo and Paul Mather Cristina Disabatino Kevin Disabatino Alan DiSiena Jane Donovan Shannon Dosemagen Alisa Drelick Bill Drelick Jessica Dumerve Allison Dungen Vikki Dunn Katherine Echeverria Laura Edwards Michael Eggen Annaliese Ehlen Alison Eichmann Alana Ennis Alison Fairbrother Brian Feinstein John and Emily Ferraro Laurie Ficher Matthew Finkenaur Frances Fisher Miranda Fix Alison Flynn Whitney Fogg Katherine Folts Gaby Fox Ali Fraenkel Leslie Freehill Mary Freeman Margaret Freifeld Grant Fuller Aubra Funk Laura Futransky Laurel Gamm Katherine Ganim Rosemae Garibotto Sue Garnett Natalie Gart Mariposa Garth-Pelly Bruce Gaynor Blake Gearheard Erna Gelles Jeromy Gensch Cody Germain Deborah Gesser Anca Giurgiulescu Bernadette Glasgow Mike Weaver and Carolyn Golaszewski John Goldberg Louise and William Goldstein Todd and Laura Goodwin Paul Gravel Kristen Grennan Julie Grey Jim Haber Alexis Hannis Alexandra Harlig Alex Harsha Zayda Harsha Taher Hasanali David Hashim Morgan Hass Emily Hauck Marilyn Hayward The Hayward Family Barrett and Mary Frances Hazeltine Alex Helsinger Cathy Hendrix Gerald Hildebrand Edyssa Hise Marcia Hoffer Martin Holm Rachel Hooper Michael Horrell 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Box 426081 Cambridge, MA 02142 www.malihealth.org | info@malihealth.org The Mali Health Organizing Project is a 501(c)(3) nonprofit