Health in the Central African Republic

The Ministry of Health and Population (Ministère de la Santé et de la Population (MSP)) directs health policy and regulation. Regional directorates, health districts and their technical teams organize care. The network includes public, private, faith-based and nonprofit facilities, as well as facilities operated by nongovernmental organizations. A partner organization does not automatically mean that a government-funded service is available. The Central African Republic is divided into seven health regions and 35 health districts. The researched national overview lists five central hospitals, five regional hospitals, 27 district hospitals, 395 health centers and 567 health posts. A 2025 WHO survey counted 1,014 health facilities. A separate HeRAMS assessment evaluated a total of 1,083 health units as of 31 May 2025. The differing figures reflect different dates, definitions and counting methods and do not demonstrate stable availability nationwide. Access usually begins at the nearest functioning health facility (Formation sanitaire (FOSA)), health center or health post. Registration, examination and triage, meaning assessment by urgency, follow. Depending on the findings, tests and medicines may be provided, or the patient may be referred to a district hospital or to a regional or central hospital. Distance, road conditions, the security situation, staff, electricity supply, water and supply shortages can delay referral and treatment. The current condition of the specific district should therefore be checked locally each time. Common health burdens include malaria, vaccine-preventable and epidemic diseases, risks for mothers and newborns, childhood illnesses, malnutrition, HIV and tuberculosis. In 2025, measles, whooping cough, meningitis, rabies, mpox and vaccine-derived poliomyelitis were among the diseases reported; there was also a risk of the reintroduction of cholera. WHO reported malaria incidence in 2022 at 354.5 cases per 1,000 people at risk and tuberculosis incidence in 2023 at 428 cases per 100,000 people. The routine immunization program (PEV/EPI) provides routine vaccinations through fixed facilities, mobile activities and community-based sites. The focus is on children aged 0 to 11 months. Campaigns target measles and polio, among other diseases, as well as children with no or incomplete vaccination protection, and may partly include vitamin A. Preventive Ebola vaccination of health workers and community health workers in all 35 districts was planned for 2026. The vaccination card and actual availability depend on the specific location. Pregnancy and childbirth involve particular risks. Published estimates of maternal mortality differ: WHO reported 2023 829 deaths per 100,000 live births, while UNICEF reported source year 2024 882. Neonatal mortality is approximately 28 per 1,000 live births, about 42 percent of births take place at home, and fewer than half of women reached four antenatal visits in the most recently cited WHO assessment. More than 1,200 community midwives were active in 32 of the 35 districts. Heavy bleeding, seizures, very high blood pressure, obstructed labor, fever, or breathing or feeding problems in a newborn require immediate referral. In a supported child health program, malaria accounted for about 48.7 percent of treated illnesses in 2024, acute respiratory infections for 30.4 percent and diarrheal diseases for 20.8 percent. Health centers and partners also provide nutrition and child health services, whose coverage varies by area. Services for noncommunicable diseases and mental health also exist but remain fragmented locally. Relevant severe conditions include sickle cell disease, rheumatic heart disease and type 1 diabetes. The national list of essential medicines and medical devices provides a basis for procurement. The MSP, UNICEF, WHO and other partners support supply chains, but stockouts and problems with refrigeration and electricity occur. Before taking a medicine, its packaging, expiry date, dosage and, where applicable, prescription should be checked. A particular pharmacy or an equivalent substitute is not guaranteed nationwide. Targeted free services are available for pregnant and breastfeeding women and for children under five. HIV and tuberculosis programs, as well as some other programs, may also provide free examinations, tests or medicines. In seven supported districts, medicines for pregnant women and children under five were designated as free. Eligibility, stock, district and partner coverage nevertheless vary; there is no general free provision of all health services. The Constitution and health-policy foundations recognize access to public health facilities and appropriate treatment by qualified staff with suitable equipment. Practical availability does not automatically follow from this. The free information and complaints line (MSP-Ligne verte 1212) is available around the clock. Its use as a nationwide medical emergency or ambulance service has not been confirmed; no single nationwide emergency number for ambulance services was found in published sources. In an acute emergency, the priority is therefore to travel as quickly as possible to the nearest functioning facility, using private, community or partner-supported transport if necessary. Traditional practitioners (Tradipraticiens) and traditional medicine are documented but are mostly informal. A formal national policy integrating traditional medicine and a reliable nationwide licensing and quality pathway have not been confirmed. Traditional treatment therefore does not replace urgent referral or treatment for severe malaria, HIV, tuberculosis, or obstetric and neonatal emergencies. After treatment, discharge instructions, medicine use and referral appointments should be followed. If the condition worsens, the person should seek care again immediately, because distance, insecurity, supply shortages and staff changes can interrupt follow-up care. Truthful information about medical history, available vaccination and treatment records, and compliance with prescription, referral and hygiene rules make ongoing care easier.