The political and military crises of 2002 to 2010 have taken a severe toll on the Ivorian health system. According to the World Health Organization, it is one of the weakest in Africa, with only one medical doctor and five midwives per 10,000 inhabitants. As the maternal mortality rate is very high, the Ministry of Health has made maternal healthcare one of its main priorities, offering it free of charge to all pregnant women. However, budgetary restrictions, drug stockouts and a lack of trained health personnel, among other factors, continue to hamper access to good-quality medical services for women and young children.

In Hambol region, where the mortality rate is estimated at 661 per 100,000 live births, according to a 2015 Epicentre survey, MSF runs a project in collaboration with the Ministry of Health.

The team aims to improve care for obstetric and neonatal emergencies in this rural setting by supporting Katiola referral hospital and 27 primary health centres in the region. In 2017, MSF also started to rehabilitate parts of Dabakala hospital, such as the operating theatre, in order to improve the management of caesarean sections. MSF supports all these facilities with medical supplies and personnel and operates an efficient referral system for complicated deliveries. Training, coaching and supervision of Ministry of Health staff form a significant part of MSF’s programme.

Every month in 2017, on average, 415 deliveries were assisted in MSF-supported facilities, including over 40 caesarean sections, and 64 newborns were admitted to the neonatal ward at Katiola hospital.