With more than 22 million people, Côte d’Ivoire is Africa’s fastest growing economy. However, political and economic crises of the last several years have negatively impacted the country’s fragile health system. Despite recent high rates of economic growth, the country’s health indicators remain low. There are high rates of maternal and child mortality and malaria, and it also has an estimated HIV prevalence rate of 3.5% — one of the highest in West Africa.
Founded in 1991, PSI/Côte d’Ivoire has over 25 years of experience working on health projects throughout the country. PSI/Côte d’Ivoire has worked in the areas of HIV/AIDS, family planning, malaria, child survival, and sanitation. It has worked with the general population on such programs as mosquito net distribution and communication, as well as with specific populations such as the military, truck drivers, migrants and sex workers, on HIV programs.
PSI/Côte d’Ivoire estimates that in 2015, its products and services helped avert 6,464 DALYs, including, by health area:
- 2,317 HIV DALYs
- 1,765 FP DALYs
- 2,327 MNCH DALYs
- 55 WASH DALYs
PSI/Côte d’Ivoire’s family planning programs also provided 6,674 couple-years of protection.
PSI/Côte d’Ivoire’s strong partnerships with government ministries, international and local organizations help reach a broad range of target groups across the country through the following projects:
HIV/AIDS Prevention, Care and Treatment Support for the Ivorian Defense Forces
PSI partners with the Ivorian Ministry of Defense’s HIV/AIDS Committee to increase the capacity of the Ivorian military health system, to address the HIV epidemic affecting the military and their families. The program has three objectives:
- Strengthen military health facilities and human resource capabilities to provide sustainable quality services.
- Increase the number of military, families and sex workers who know their HIV status and are enrolled in care and treatment if necessary.
- Strengthen the military health information collection system to facilitate more effective data analysis.
PSI’s direct activities with the military include testing and referral to treatment, and overseeing prevention awareness activities. At the structural level, PSI uses its technical expertise to improve the ability of three military laboratories to provide quality professional services in line with international norms. PSI is also working with the military to improve their data collection and reporting system, so that they can better understand and track their patients.
Sanitation Service Delivery Program
PSI/Côte d’Ivoire is the headquarters of the Sanitation Service Delivery Program (SSD), a USAID/West Africa urban sanitation project implemented in Côte d’Ivoire, Benin and Ghana. The goal of the program is to improve sanitation outcomes. By developing and testing scalable business models that engage private sector service providers and public sector actors, it can create a strong enabling environment for sanitation in West Africa. In Côte d’Ivoire, the main objectives of this five-year, program are to:
- Increase use of basic sanitation for 500,000 persons;
- Increase safe disposal of fecal waste for 500,000 persons; and
- Share learning on market-based approaches to the provision of sanitation services throughout West Africa.
SSD is using learning and insights gained from market research and product design to iterate on, and effectively execute, two business models in Abidjan:
- Healthy Compound model, which proposes the septic tank system as an acceptable, appropriate and affordable sanitation solution to consumers without access to basic sanitation. Prefabricated septic tanks under this model will have a maximum capacity of six cubic meters to serve up to 60 users, ideal for compound households, and will be constructed with pour flush toilets and appropriate superstructures.
- Vidange Plus/Call Centre model aims at connecting households to high quality septic tank emptying services to ultimately reduce the cost of emptying, and improve quality of service rendered by vacuum truck operators. Success of this model will increase safe fecal waste management.
TRANSFORM/PHARE Regional Program
The purpose of the TRANSFORM Project is to generate innovative and evidence-based social and behavior change communication (SBCC) strategies that address barriers to modern contraceptive use, transform attitudes about reproductive health, and promote family planning in West Africa.
Côte d’Ivoire is one of three countries selected for the first two years of the project, where three innovative practices are being tested:
- Conduct formative qualitative and quantitative research to apply the attitudinal and behavioral segmentation strategies to identify family planning (FP) needs for groups of women with similar needs and preferences, based on similar behaviors and attitudes towards contraception – also referred to as ‘segments of women.’
- Conduct a landscape analysis to assess the full range of FP and SBCC implemented interventions, and apply a market development approach in order to identify and prioritize family planning market failures, particularly as they relate to the SBCC market.
- Conduct a barrier analysis and positive deviance study of family planning providers, in order to assess provision of FP services to all women and couples in need with the aim of incorporating identified traits that may serve to recruit, train and develop family planning health care providers.
In 2017, a fourth initiative is taking place: using a human centered design approach, PSI will identify plausible solutions for young men (aged 15-24) working in the informal sector of the economy, to engage in discussions about contraception amongst themselves and with their sexual partners.
- U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)
- U.S. Agency for International Development (USAID)
- Côte d’Ivoire Ministry of Health
- Côte d’Ivoire Ministry of Defense
- Côte d’Ivoire Ministry of Defense/ HIV/AIDS Committee
- Ministry of Sanitation and Hygiene
- Ministry of Construction
- Mayors of the cities of Abobo, Yopougon and Attécoubé
- Camber Collective
- African Water Association (AfWA)
- House Renters and Owners’ Association
- Federation of Vacuum Truck Operators
- Microfinance companies
- Institut européen de coopération et développement (IECD)
- Innovations for Poverty Action (IPA)
- REAL (Indian NGO)
- Local and international NGOs
- Transform/PHARE Creative Sparks
Creative Sparks compiles examples of participative methods to design interventions and also examples of HCD processes implemented in Benin (Academie de l’Artisanat) and Cote d’Ivoire (Didier).
- Didier Playbook
This resource provides guidance for live prototyping a social media-led approach that initiates dialogue on sexuality and gender equity with the target audience in Abidjan.
- Didier: Engaging Young Men in the Informal Sector
- National Demand Analysis – Quantitative Study and Target Group Segmentation
Randomized, nationwide representative study of FP needs and analysis of behaviors and attitudes of women.
- National Demand Analysis – Qualitative Assessment
Qualitative analysis of family planning needs in Cote d’Ivoire to inform quantitative research leading to behavioral/attitudinal segmentation.
- Analysis of the Social Networks of Family Planning in the Zinder and Maradi Regions (Sawki Project Sites)
Social network analysis proves useful to identify influencers of specific target audiences, such as “sheltered skeptics” according to a segmentation study conducted previously in Niger.
- Transform/PHARE SBCC Landscaping Using TMA
Conducting SBCC landscaping with an overall overview of the market helps understand the place for communications – to all actors – related to the FP market; suppliers and providers may also benefit from a better perspective of the clients’ needs, barriers, and aspirations.
- Analysis of Obstacles and Barriers to the Offer of Family Planning by Providers
Provider barriers in Cote d’Ivoire are not too different than those found in the region and worldwide. The most important limitations observed are personal biases, whether social, cultural or religious, along with misinformation or misconceptions on methods and side effects. Providers who manage to succeed overcoming such barriers seem to show empathy, active listening skills and have made an effort to understand all available methods to give the choice to the client.
- Catalyzing Markets for Urban Sanitation in West Africa
- Shaping the Family Planning Market by Strengthening the Public Sector
PSI considers total market approaches to be critical for achieving universal health coverage, especially when it comes to contraception. This program brief presents cases, supported by several different donors, which take into consideration the total family planning market.