Strength and Sustainability: A Look at Cote d’Ivoire’s Health System

Jordan Hacker, MPH ’11 in Health Policy and Management

Jordan Hacker (right) working in ICAP Cote d'Ivoire office

On October 31, 2010 Cote d’Ivoire held its first presidential election in ten years. After years of civil war and subsequent economic deterioration, the elections are the start of a new era for Cote d’Ivoire. The new future, as convincingly described by the presidential candidates, includes a stronger economy, wider access to education and improved health systems.When I asked the teenagers who were exuberantly dancing to Beyoncé in a political campaign outside my office what they thought of these candidates’ promises, they all agreed: they are optimistic, but possible.

The argument over vertical health interventions (i.e., interventions that target a single disease) vs. horizontal health interventions (those that seek to address broader health care system issues) is a controversial one. However, my work at the International Center for AIDS Care and Treatment Programs (ICAP) demonstrates that a targeted HIV/AIDS program can have a lasting impact on the larger health system. Strengthening health systems through HIV/AIDS services can be a successful way to ensure improved access to health for this population.

ICAP has been in Cote d’Ivoire since 2008 when the civil war ended, and it currently supports over 60 care and treatment sites throughout the country.  In implementing AIDS interventions, ICAP has made great strides in strengthening a sustainable health system.

Cote d’Ivoire has a generalized but stable HIV epidemic that is particularly problematic in rural parts of the country where there is limited access to health care. Interventions here not only address HIV, but also create sustainable solutions for the future.  Instead of building new clinics, we help renovate and upgrade existing ones. Instead of financing doctor’s salaries, we finance the government health districts to train and pay doctors. Instead of purchasing drugs, we work with the government’s pharmaceutical organization to supply patients with necessary medicines.

Cote D'Ivoire campaign posters

Sustainability is crucial. Working within the local context enables the government to have more control over the health sector. With the right governance, it can increase access to health services and the quality of medical care for the population. It is important to consider in the long run, how a country will be best suited to support its people. The recent election has given this country a chance to define itself again and possibly regain its former glory. With locally developed and stronger systems in place, Cote d’Ivoire can achieve a healthier future…hopefully with lots of dancing to the music of Beyoncé.
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