Maternal healthcare in Mali faces significant challenges, including high mortality rates and limited access to services. There is a need to understand local perspectives on what constitutes acceptable and sustainable innovation within this context. This study aimed to explore local stakeholder perspectives on innovative approaches to maternal healthcare in Mali. Its objectives were to identify themes defining innovation from a local viewpoint and to understand perceived facilitators and barriers to implementation. A qualitative study was conducted using semi-structured interviews and focus group discussions. Participants included community health workers, traditional birth attendants, women of reproductive age, and clinical staff from selected rural and urban settings in Mali. Data were analysed using thematic analysis. A predominant theme was that innovation was valued most when it integrated local knowledge with biomedical systems, rather than replacing existing practices. Participants expressed a strong preference for community-based mobile health initiatives that worked in partnership with traditional birth attendants. Innovations perceived as externally imposed without community consultation were met with scepticism. Successful innovation in Malian maternal healthcare is contingent upon respectful collaboration with existing community structures and knowledge systems. Approaches that are co-developed and build upon local practices are more likely to be accepted and sustained. Policymakers and programme designers should prioritise participatory models of innovation that formally integrate trained traditional birth attendants into the healthcare system. Future interventions should allocate resources for community dialogue and adaptation prior to implementation. Maternal health, innovation, qualitative research, Mali, community health, traditional birth attendants. This study contributes an in-depth, local perspective to the discourse on healthcare innovation in Sub-Saharan Africa, providing evidence that can inform more culturally resonant and effective maternal health programmes in Mali.
Diakité et al. (Sat,) studied this question.