Intention de quitter les services de premier niveau chez les sages-femmes et infirmières-obstétriciennes au Mali

Translated title of the contribution: Midwives’ intention to leave primary level care services in Mali

Cheick Sidya Sidibé*, Fatoumata Bintou Traoré, Assa Keita, Ousmane Touré, Marjolein Dieleman

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Background: Mali is a country with a high rate of maternal and neonatal deaths and a low density of human resources for health. The health system faces understaffing and inequitable distribution of available resources. Health staff are reluctant to take positions and stay in first level care services. This study examines midwives and obstetric nurses’ intention to leave their current positions in first level structures and management factors that influence this intention. Methods: A cross-sectional mixed method study was conducted with 220 midwives and obstetric nurses in 46 primary healthcare services of three health regions. Questionnaires and interview guide were used. Descriptive statistics and bi-varied analyses tested the links between managerial practices, demographic characteristics and intention to leave. A thematic analysis of the qualitative data examined the factors underlying the intention to leave. Results: Nearly half of midwives and obstetric nurses in primary healthcare services had the intention to leave their current positions. This intention to leave is more marked among midwives who have very little attraction for first-level service. Age, type of structure and area of assignment are strongly associated with the intention to leave. Managerial practices that differ according to locations and type of structures seem to influence the intention to leave. Conclusion: There is a high intention to leave their position among midwives and obstetric nurses in first level services. Managerial practices seem to have more influences on the intention to leave in rural areas and among obstetric nurses.

Translated title of the contributionMidwives’ intention to leave primary level care services in Mali
Original languageFrench
Pages (from-to)725-735
Number of pages11
JournalSante Publique
Issue number5
Publication statusPublished - Oct 2018


  • Intention to leave
  • Mali
  • Midwives
  • Obstetric nurses
  • Primary healthcare service


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