On the challenges to providing greater and more efficient access to health care What are the main challenges facing Côte d’Ivoire with regard to its disease burden?
ERIC DJIBO: As the economy develops, Côte d’Ivoire will need to invest more in treating incidences of both infectious and non-communicable diseases. In line with this strategy, health care facilities will have to develop multidisciplinary care services, while both existing health centres and those under construction equip themselves with the technology needed to combat new strains of disease. The overall objective is to increase the efficiency with which patients are diagnosed and treated, while benefitting overall health care provision.
Additionally, new skills will be required to help health professionals adjust to the country’s new epidemiological profile. Hence, health care centres are boosting training and partnerships to equip their employees with the necessary knowledge for the future. These initiatives will help experienced workers confront unfamiliar situations and adjust smoothly to the new cases they will face.
What can be done to ensure the sustainability of universal health care coverage?
DJIBO: Currently, the system is only concentrated on a handful of diseases and targeted populations, and therefore not yet at risk of financial default, provided it effectively manages its bottom line. However, considering the government’s plans to extend the range of services and people covered, the system will eventually encounter a higher level of financial pressure. This will make it necessary for the National Health Insurance Fund (Caisse Nationale d'Assurance Maladie, CNAM) to revaluate the scheme of contributions and services it offers to the Ivorian public. Côte d’Ivoire is not the first to be faced with this challenge, and upcoming policies could take inspiration from countries that have already dealt with a similar situation.
Additionally, officials can improve operational efficiency at hospitals by regulating the types of health coverage provided by private insurance groups. Indeed, the wide range of health coverage conditions creates additional steps for health workers when taking charge of a new patient. To avoid prohibitive costs, for example, they can establish the terms of a patient’s insurance before administering care. Establishing a clear framework for types of health care coverage will not only help accelerate patient care, but also relieve CNAM from the financial pressure created by excess bureaucracy.
How can rural access to health care in Côte d’Ivoire be improved?
DJIBO: Improving access to health care in rural areas is the government’s responsibility, and officials have implemented a set of measures to accompany the rehabilitation of existing facilities and the inauguration of new ones. As a result, several renovation projects involving Abidjan’s University Hospital Centres have been implemented. Having said that, the improvement of health conditions in the countryside also depends on the development of every level of health infrastructure, as well as the quality of equipment available to doctors and health workers. Developing primary health care centres closer to where people live is also important, as these facilities serve to relieve the patient burden on hospitals.
Attracting qualified personnel is also imperative, as these facilities cannot run properly without a team of competent health professionals. Despite having high-profile universities and medical training centres, the education system – beset by recurring strikes – has failed to supply the job market with qualified professionals. For example, such institutions have not been able to adequately prepare qualified paramedics. However, collaborative measures between France and Côte d’Ivoire should help foster knowledge transfer between medical personnel of both countries.
Lastly, improving transport connectivity to villages and small towns is also a mandatory step towards the improvement of rural health care conditions. Understandably, patients might not necessarily have the opportunity or means to travel to their closest hospital; therefore, investing in mobile health care facilities could help reach the most isolated communities.
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