Highlights of a technical brief from the Institute of Development Studies
Côte d’Ivoire faces a double burden of both communicable and non-communicable diseases, while nearly a decade of political crisis (2002-2011) has eroded the state’s capacity to manage its health system. The nation has seen greater political stability and robust economic growth for several years post-crisis, however. This suggests there is the potential to expand support to its health systems.
Tackling deadly diseases in Africa (TDDA) works with Côte d’Ivoire to improve health security and save lives. Integrating social science perspectives into TDDA’s technical assistance work provides important benefits. It strengthens our understanding of the contexts in which we operate and informs the support we give. It can also help to shape emergency response systems so that they are more effective, adaptive, evidence-based, and planned in consultation with affected and at-risk communities.
The Institute of Development Studies is a valued resource partner to TDDA. With our support, they have recently produced a series of technical briefs, detailing the key political, economic, cultural and social issues facing each of the countries we work with. Here is a snapshot of their findings for Côte d’Ivoire.
Key considerations and recommendations in Côte d’Ivoire – summary
Improved health infrastructure: Additional financing is needed to address the quality of services and access, particularly for rural communities. This requires investment in skilled staff, facilities, equipment and medicine supplies.
Policy and planning focus: Whereas the national system is predominantly built around curative medicine, more focus could be given to the social dimensions and drivers of disease, emphasizing prevention rather than treatment alone.
Greater collaboration: Parallel systems operate across the private and public health sectors as well as between conventional and alternative medicine. Greater cooperation is needed and could be achieved through existing informal mechanisms. Alternative medical practitioners must be included in any coordination.
Improved data: A lack of information about how central and regional health structures are organised and functioning, and on vulnerable populations, is an obstacle to effective epidemic preparedness and response. The state could leverage community health workers and existing village-level infrastructure to build reporting and referral mechanisms, using low-tech solutions like text messaging.
Strengthening trust: Crises have deeply eroded social ties and trust in political authorities. Health service provision needs to be adapted to local customs and needs, and health staff and volunteers should be recruited locally whenever possible, to improve local ownership of health care.
Health inequality: The lack of access to public health facilities in rural areas means that few people seek medical attention and many seek care from alternative providers. This influences perceptions of the health sector and damages trust in the health system. The state needs to bolster investment in public health infrastructure and health workers in poorly-served areas.
Linking communities and the health system: Health services should be adapted to the realities of the sick, their local vulnerabilities and health beliefs. Without this, sick people might be concealed or may migrate, rather than seek help. Scaling up the community health worker model and enlisting alternative health providers to support surveillance, risk communication, the delivery of treatments and referrals can both deliver benefits. Greater intercultural understanding can help to tailor risk communication to at-risk populations.
Community engagement in epidemic preparedness and response: Communities are rarely engaged in the health sector or epidemic response at present. This is a problem when communicating around a disease or epidemic, meaning that rumours can go unchecked. More inclusive communication approaches, the country can address misinterpretation and misinformation, and encourage support.
The IDS technical brief was authored by Firmin Kra & Megan Schmidt-Sane.
Read the full document here: