Côte d'Ivoire

Côte d’Ivoire has a maternal mortality rate of 614 deaths for 100,000 births, 15% of which are due to complications caused by unsafe abortions. In other words, one to two women die giving birth every day in Côte d’Ivoire.

In 2014, Médecins du Monde carried out a study in Abidjan with 450 people who use cocaine, heroin and crack on a regular basis. The study shows that people who use drugs are vulnerable to infectious diseases due to risky sexual behaviour, their consumption of drugs and precarious living conditions.

The prevalence of HIV amongst people who use drugs in Abidjan dropped from 9.8% in 2014 to 3.4% in 2019, according to a study carried out by the firm CECAF for the national programme for the fight against AIDS. Sexually transmitted diseases are particularly high amongst people who use drugs, especially syphilis, with a prevalence of 9.3%. Similarly, the prevalence of tuberculosis amongst these individuals is higher than in the general population (according to the study conducted by the firm CECAF, 2.9% caught it in 2019), which leads to many cases of HIV/tuberculosis co-infection. 12.1% of people who use drugs have hepatitis B.

In 2016, Médecins du Monde carried out a study on sociocultural factors for unintended pregnancies: it demonstrated that the sexual and reproductive health services available to adolescent girls are inadequate. The data from a study carried out in April 2019 indicated that only 30% of young girls (aged 10 to 24) who are sexually active use a modern method of contraception, 81% of whom use the male condom. 10.3% of young girls interviewed for a survey have been pregnant at least once, and 36.4% of pregnancies end in abortion – 60% of which are unsafe abortions.

In 2017, Médecins du Monde carried out a project in support of the health system to improve prevention and unintended pregnancy care for adolescents and young people in the Nawa region (west of the country) using a rights-based approach.

This project ended in 2020. Médecins du Monde produced in partnership with the production company Wendigo a 52-minute documentary to improve the understanding of the key issues of unsafe abortions for women.

To help solve the issue of access to family planning services for women, young and adolescent girls, Médecins du Monde’s advocacy work is national, and the organisation is co-building with local and international players for the availability and the funding of family planning inputs. Our advocacy work is the cornerstone of our humanitarian mission in Côte d’Ivoire and underlines some alarming health issues.

Since January 2015 in Abidjan, Médecins du Monde and local partner humanitarian organisations carry out prevention and harm reduction (HR) initiatives for people who use drugs. The aim of that programme is to improve the health system’s care and its access for those populations. Médecins du Monde endeavours to empower these people to develop the appropriate responses and fight against stigmatisation, exclusion and criminalisation, which constitute barriers to access to care.

The CASA (addiction care and support centre) opened in 2018 is highly successful amongst people who use drugs. This centre offers community-based holistic care for people who use drugs. It is in this centre that for the first time in Côte d’Ivoire, methadone, an opioid substitution treatment (OST), is currently given to fifteen people who use drugs.

The third phase of the project (2021 – 2023) expands interventions to greater Abidjan, in Yamoussoukro, Bouaké and San Pedro. As in previous phases, three approaches are developed: the outreach model directly on consumption sites; the integrated model, aiming to strengthen the national health facilities to provide care for people who use drugs tailored to their needs; and the dedicated model which consists in creating or strengthening care centres dedicated exclusively for the people concerned.