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Expanding HIV/AIDS Services for Pregnant Women in Côte d’Ivoire
– Reported, July 26 2014
Côte d’Ivoire, a West African country of about 19 million people, has seen its share of turmoil in the last 20 years. Once referred to as the “Paris of West Africa” due to its astounding economic growth and development in the 1980s, Côte d’Ivoire has since been rocked by civil conflicts spanning two decades that have divided the country in a rebel-controlled northern region and a southern region under government control. The effects of the most recent war, begun in 2002, are far reaching and long-term; at one point, more than 80% of health care workers had fled the war torn areas, leaving health care facilities untended, looted, and largely empty.
Compounding this breakdown of the public health sector services were troubling–and worsening–health indicators. Côte d’Ivoire has one of the highest rates of HIV in West Africa, and with health facilities closed and services unavailable, women had trouble accessing vital prenatal and delivery care services. And if they wanted HIV care as well, they often had to visit several sites, travel long distances, or be turned away due to an overwhelming demand. Today, as the country continues to rebuild under a reunified government, health facilities are slowly regaining their capacity to deliver essential health services to Ivorians.
Integrating Services into Prenatal Care and Building Support for Women
Health Alliance International (HAI) has been active in Côte d’Ivoire since 1992, but due to political violence over the years, our programs were halted until 2007. At that time, we conducted community assessment in Bouak, located in the center-north region of the country, to investigate how best to help our Ministry of Health partners strengthen health systems and provide greater access to quality health care to Ivoirians. Through records reviews, interviews with Ministry of Health officials, health care workers, other NGO workers, and local citizens, a complex system of how health care was delivered to people was revealed.
During the war, public health facilities were routinely looted and destroyed, and health care workers fled the region for the relatively more stable regions of the south. Large international donors, including UNICEF, provided financial and technical assistance to rebuild many of these facilities as peace returned to the north, but in the interim, more than 500 NGOs entered the healthcare scene, many of them providing HIV testing and care services.
Unfortunately, though, the majority of these organizations provided only pieces of
HIV care–only testing, for instance, or only psychosocial support services–and none of them provided comprehensive outpatient or maternity care. That meant pregnant women seeking HIV testing and prenatal care were sent on a long, tedious journey to several sites in the city, overcoming obstacles of time, transportation, and cost to access services.
The resulting health care system was weak, fragmented, and women and their children often slipped through the cracks and were lost to follow up.
An additional goal of the project was to increase community awareness of the importance of HIV testing and follow up. Based on our successes in Mozambique, we created radio spots and initiated support groups for HIV positive mothers. The support groups were held at the local public health facility, creating further linkages to the health site and offering a way for women to learn about how to manage the disease, how and where to access additional services, and share challenges and successes with each other as moral support.
CREDITS:
http://www.healthallianceinternational.org