Countries like Senegal and Mali are particularly successful examples of how needs-based interventions can bring about change. For example, Senegal, in its country programme, successfully carried out three specific maternal mortality reduction projects focused on the construction, renovation and equipping of health centers and rural maternity units. The goal is wider access to emergency obstetric care and quality family planning services. Other elements of the projects included community-level information activities and improvement of contraceptive supply logistics. The programme also disseminates information to youth, parents and decision-makers about the dangers of early marriage and pregnancy, which include much higher rates of maternal death and disability.

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In Mali, interagency collaboration has enabled the country to build and equip seven new community health centers in three regions and a new maternity unit. The government of Mali, with support from various donors, developed a programme to bolster its referral system with a rapid-response component. The country has invested in radio communication among referral centers, and has procured vehicles to use for patient transport.

District hospitals and local health centers are now linked by a two-way system of radio communication and transportation. A car, equipped with a stretcher, is available to transport women from health centers to district hospitals. Under this system, the time required to transmit an urgent message and transport a patient is reduced from up to a day to just a few hours. Obstetric services are paid for on a cost-sharing basis between village health committees and district authorities. A post-payment arrangement ensures that financial barriers do not impede emergency care. Already, there has been a steady increase in the number of women referred to district level hospitals and in the proportion of caesarean sections to births per district, which currently still is a low 1 to 2 per cent, which suggests that many women continue to suffer the consequences of obstructed labour.