["Safe motherhood initiative: from control to trust." Anthropologic analysis of risk in Mali (West Africa)].
OBJECTIVE
This article addresses risk management in maternal health in Mali. Risk concept is used as a tracer to investigate uncertainties and their answers at the different levels of maternal health. Representations and practices related to risk are analyzed through concept of trust and uncertainties linked to the maternal health system reform.


METHODS
We investigated the conceptions and practices related to risks, changes and uncertainties through qualitative investigations and analyses, taking into account different levels of health reforms (policy-makers, regional managers, practitioners, consumers). Forty-nine qualitative and semi-structured interviews were carried out in urban, semi urban and rural environment in Mali.


RESULTS
In order to reach a better management of risk in maternal health, through action coordination, it is necessary to analyze real, observed and perceived risks through its different meanings. Depending on representations, risk is seen as measurable data or uncertainty; all revealing specific approaches of unpredictable event.


CONCLUSIONS
Safe Motherhood call for a better control on danger associated to pregnancy and birth. Such control is allowed by the elaboration of a relation of trust between population and its health system.
Arborio
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MCF anthropologie sociale, UHP Nancy, 30, rue du Jardin-Botanique, 54600 Villers-les-Nancy, France. sophie.arborio@staps.uhp-nancy.fr
D000328:Adult; D003906:Developing Countries; D005260:Female; D006291:Health Policy / Q000331:legislation & jurisprudence; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008302:Mali; D008427:Maternal Health Services / Q000458:organization & administration* / Q000592:standards; D008428:Maternal Mortality; D009752:Nutritional Status; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011256:Pregnancy Outcome; D012306:Risk; D018570:Risk Assessment; D012307:Risk Factors; D012308:Risk Management; D012424:Rural Population; D011795:Surveys and Questionnaires; D014505:Urban Population