Public Health

In Côte d'Ivoire, access to quality healthcare and the well-being of the population are central to government priorities. Within this framework, the vision of a "Côte d'Ivoire where the health and well-being of the population are maximized through an efficient, accessible, and resilient healthcare system" has been incorporated into the National Health Development Plan (PNDS) 2021 - 2025.

This vision will concretely translate into an improvement in the well-being of populations through:

• The increase in life expectancy from 57 years in 2020 to 60 years in 2025; 

• the reduction of maternal mortality from 614 per 100,000 live births in 2020 to 377 per 100,000 live births in 2025; 

• the decrease in infant and child mortality from 96 per thousand in 2020 to 60.5 per thousand in 2025; 

• the reduction of neonatal mortality from 33 per thousand in 2020 to 22.5 per thousand in 2025.

The achievement of these objectives requires the implementation of the three strategic pillars of the National Health Development Plan (PNDS) 2021-2025:

Axis 1: Improving governance and health financing, particularly through (i) the completion of hospital reform, (ii) the integration and development of the private health sector, (iii) the effective operationalization of health districts and regions, the expansion of performance-based financing, and (iv) the digitalization of the health sector.

Axis 2: Strengthening the supply and accessibility of quality healthcare for populations through (i) the widespread implementation of Universal Health Coverage (UHC) in healthcare facilities, (ii) the establishment of Regional Health Excellence Centers (RHECs) to implement the Continuum of Care approach for the development of a local healthcare network, (iii) the enhancement of Human Resources in Health, and (iv) the improvement of the availability of quality health products (blood products, vaccines, medications, and strategic inputs) in sufficient quantities.

Axis 3: Strengthening health promotion and disease prevention, particularly through (i) enhancing the provision of services tailored to mothers, newborns, and children, and (ii) intensifying efforts to combat diseases.

The Ivorian public health system is pyramidal in structure, featuring an administrative or managerial aspect and a care provision or service provider aspect.

The administrative or managerial aspect of the healthcare system, organized into three levels, includes:

• At the central level: the Minister's Office, Central Directorates and Services, and Health Programs. These structures are responsible for defining policy as well as providing support and overall coordination of health initiatives.

• At the intermediate level, 33 Regional Directorates are tasked with supporting health districts in the implementation of health policy.

• At the peripheral level: 113 Departmental Health Directions or Health Districts are responsible for coordinating health actions within their territorial jurisdiction and providing operational and logistical support to health services. Furthermore, the health district, which serves as the operational unit of the health system, is subdivided into health areas that represent the service catchment area of a primary healthcare 

facility.The healthcare service provision side is organized around three (03) levels, which are:

• The primary or peripheral level consists of all public health facilities that provide first contact services to users, offering curative, preventive, educational, and promotional care.

• The secondary level comprises all public healthcare facilities that provide primary care for cases that cannot be managed at the primary level. These facilities have a more advanced technical capacity for diagnosis and treatment. This includes public General Hospitals (GH), Regional Hospital Centers (RHC), and Specialized Hospital Centers (psychiatric hospitals in Bingerville and Bouaké)..

• The tertiary level comprises all public health structures that provide a secondary care function for cases that cannot be managed at the secondary level, possessing technical capabilities for diagnosis, treatment, training, and research.

It is primarily composed of National Public Institutions (NPIs) which are:

• Five (5) University Hospital Centers (UHC): Cocody, Treichville, Yopougon, Bouaké, and Angré; 

• Five (5) Specialized National Institutes: National Institute of Public Health (NIPH), National Institute of Public Hygiene (NIPH), Raoul Follereau Institute of Côte d'Ivoire (RFCI), Pierre Richet Institute (PRI) for the management of trypanosomiasis, Abidjan Cardiology Institute (ACI); 

• Five (5) additional National Public Support Establishments: National Blood Transfusion Center (NBTC), National Public Health Laboratory (NPHL), Emergency Medical Assistance Service (EMAS), National Center for the Prevention and Treatment of Kidney Failure (NPTKF), Alassane Ouattara National Center for Medical Oncology and Radiotherapy (NCMOR);

•  New Public Health Pharmacy (NPHP).

Since 2012, the healthcare service offering has advanced, benefiting from an increase in healthcare infrastructure, including the construction of new facilities, the rehabilitation, equipping, or re-equipping of hospitals, as well as the standardization and enhancement of the technical platforms of healthcare structures in accordance with the National Health Development Plan (PNDS).

Evolution of Public Health Infrastructure from 2015 to 2023

Source : Ministry of Health and Public Hygiene and Universal Health Coverage, Directorate of Health Information 2023.

ND: Not Available

Evolution of health indicators from 2015 to 2023

Source : Ministry of Health and Public Hygiene and Universal Health Coverage, Directorate of Health Information 2023.

ND : Not Available