Terminal Illness & End-of-Life Planning in Mali: 5-Step Official Checklist

1. 1

   Coordinating palliative care and specialised medical support

   • Hospital and specialist care: In Mali, the management of serious or chronic illnesses (such as oncology, severe organ failure, or progressive neurological conditions) is primarily coordinated through the university hospitals in Bamako (CHU du Point G, CHU Gabriel Touré, and Hôpital du Mali) and regional hospitals operating under the Ministry of Health and Social Development of Mali, in alignment with public health programmes supported by the World Health Organization [2] [5].
   • Supportive care and home-based follow-up: The treating medical team establishes a pain-management and supportive-care protocol that can be continued on an outpatient basis or at home in coordination with referral health centres (CSRéf) and community health centres (CSCom) [2] [5]. Families should request a comprehensive medical summary detailing the diagnosis, prescribed pain-relief medications, and emergency clinical instructions [2].
   • Health insurance coverage and long-term illness registration: If your family member is covered under the Mandatory Health Insurance scheme (AMO) administered by the National Health Insurance Fund (CANAM) or qualifies for the Medical Assistance Scheme (RAMED), the attending physician should submit a long-term condition declaration so that hospital stays, essential medications, and specialist treatments are covered in coordination with the National Institute of Social Welfare (INPS) [3] [4].
2. 2

   Documenting advance medical wishes and designating a trusted healthcare representative

   • Written statement of medical preferences: Although Malian legislation does not maintain a centralised electronic registry for advance directives, any adult with full mental capacity may record in writing, dated and signed before witnesses or a civil-law notary, their preferences regarding medical treatments, limits on invasive interventions, and preferred place of care (home care or hospital admission) [1] [2].
   • Designating a family medical spokesperson: In Malian hospital practice, medical teams under the Ministry of Health and Social Development of Mali consult closely with the patient's family whenever the patient is no longer able to communicate directly [2]. Formally designating a primary family representative in writing (such as a spouse, parent, or adult child) prevents family disputes and gives the attending physician a clear point of contact [1] [2].
   • Filing with the medical record: We advise providing a signed copy of these written medical preferences and the contact details of the designated family representative to the supervising hospital physician and the family doctor, while keeping an accessible copy at the patient's home [2].
3. 3

   Establishing bank powers of attorney, notarial mandates, and legal protection

   • Bank powers of attorney: While your family member retains full legal and cognitive capacity, it is important to contact their banks in Mali (or request a home or hospital visit from a bank officer) to sign an official bank power of attorney (procuration bancaire), enabling a trusted representative to pay medical bills and household expenses without interruption [1].
   • Notarial power of attorney for property administration: For broader legal and financial administration (managing real estate, collecting rent, or dealing with tax and social security authorities), the patient can execute a general or special power of attorney by authentic deed before a Malian notary in accordance with the civil rules published by the General Secretariat of the Government of Mali [1].
   • Judicial protection in the event of incapacity: If the illness later causes a lasting impairment of mental capacity that prevents the person from expressing their wishes, the Personal and Family Code (Law No. 2011-087) allows the family or the public prosecutor to petition the civil court to establish adult guardianship (tutelle) or legal administration of the person's estate [1].
4. 4

   Activating disability benefits, dependency supplements, and caregiver support

   • Private-sector disability pension (INPS): If the ill person is a salaried employee affiliated with the National Institute of Social Welfare (INPS) and the illness permanently reduces their working or earning capacity by at least two-thirds, a claim for a disability pension (pension d'invalidité) can be submitted before normal retirement age upon presentation of a detailed medical report and assessment by the fund's medical adviser [3].
   • Supplement for constant attendance by a third person: Where the disabled insured person requires continuous assistance from another person to perform ordinary daily living activities, the scheme administered by the National Institute of Social Welfare (INPS) provides a dedicated constant-attendance supplement to support home care [3].
   • Long-term sick leave and public-sector entitlements: Civil servants covered by the Malian Social Security Fund (CMSS) are entitled to statutory long-term medical leave with full or partial salary continuation, while salaried family caregivers may request statutory family-event leave or medical-assistance leave from their employer under the Malian Labour Code [1] [3].
5. 5

   Advance organisation of wills, insurance beneficiaries, and estate records

   • Drafting an enforceable will: Under Law No. 2011-087 enacting the Personal and Family Code published by the General Secretariat of the Government of Mali, any person of sound mind may organise the distribution of their estate through an authentic will (executed before a notary or judge in the presence of witnesses), a holographic will (entirely handwritten, dated, and signed by the testator), or a mystic will, subject to statutory forced-heirship rules and the applicable succession regime [1].
   • Reviewing insurance policies and beneficiary clauses: We advise reviewing all life insurance, workplace death-in-service, and loan-protection policies to verify the exact wording of beneficiary designations and to check whether benefits can be triggered early upon total and permanent disability [1] [3].
   • Centralising civil status and property documents: Assemble in a secure folder the originals and certified copies of the patient's birth certificate, biometric ID or NINA card, family record book, marriage certificate (indicating the matrimonial regime and monogamous or polygamous option), pension or salary statements, and land titles (titres fonciers) or occupancy permits [1]. Where an heir lives abroad or assets are held outside Mali, verify the consistency of civil status records with the assistance of a notary [1].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Consolidated Codes and Law No. 2011-087 enacting the Personal and Family Code — Secrétariat Général du Gouvernement du Mali (SGG)
2. [2]
   Official Health Documentation and National Public Health Policies — Ministère de la Santé et du Développement Social du Mali
3. [3]
   The Malian Social Security System (INPS, CMSS, CANAM - Sickness and Disability) — Centre des Liaisons Européennes et Internationales de Sécurité Sociale (CLEISS)
4. [4]
   Official Portal of the Mandatory Health Insurance Scheme (AMO) — Caisse Nationale d'Assurance Maladie (CANAM)
5. [5]
   Mali: Country Health Profile and Public Health Programmes — Organisation mondiale de la Santé (OMS)