Health in Ivory Coast

The Ministry of Health, Public Hygiene and Universal Health Coverage (Ministère de la Santé, de l’Hygiène Publique et de la Couverture Maladie Universelle) oversees the public health system. There are 33 regional directorates and 113 health districts. The first level comprises primary healthcare facilities (ESPC), including health centres (centre de santé), CSR, CSU, SCOM, and FSU. These provide general examinations, simple treatment, observation, and, depending on the facility, laboratory or imaging diagnostics. FSUs may additionally offer paediatrics, gynaecology and obstetrics, or dentistry. The second level consists of general hospitals (HG) and regional hospital centres (CHR), with general and specialist examinations, inpatient treatment, and laboratory and imaging diagnostics. University hospital centres (CHU) and specialized institutes provide complex diagnostics, specialist treatment, and inpatient care at the third level. According to the 2024 RASS report (RASS 2024), there were 3,286 first-level facilities, 114 HGs, and 22 CHRs. Around 82 percent of the population lived less than five kilometres from a health centre. Actual availability of staff, opening hours, examinations, medicines, and admission places nevertheless depends on the health district, the urban-rural divide, and whether the facility is in or outside Abidjan. A referral typically leads from primary care to an HG or CHR and, when complex care is needed, to a CHU; acceptance and transport should be confirmed in advance. Preventive care includes routine vaccinations, antenatal care (CPN), postnatal care (CPoN), family planning, HIV, tuberculosis, and malaria screening, nutrition services, and water, sanitation, and hygiene programmes. Routine vaccinations for children from 0 to 15 months are officially free. Community health workers (Agents de santé communautaire) support care through home visits, mobile services, and community sessions. Pregnancies should ideally begin with CPN and be monitored at a maternity facility (maternité) or another obstetric facility; complications are referred to an HG, CHR, or CHU. Malaria causes approximately 30 percent of medical consultations and, alongside HIV and tuberculosis, is among the nationally prioritized health problems. Medicines should be obtained from pharmacies or other authorized dispensing points. The prescription, authorization, and available supply should be checked. Between 2022 and 2025, the responsible authority inspected 1,119 private facilities, closed 455 of them, and seized 14.5 tonnes of substandard or counterfeit medicines. A clandestine clinic or informal seller is therefore not an equally safe substitute. After discharge or referral, keep the written recommendation, prescription, and planned follow-up appointment. Chronic conditions require repeated examinations and a continuous medicine supply. HIV has an established follow-up network, while mental healthcare, rehabilitation, and long-term care vary in accessibility by location. A nationally uniform follow-up process, a uniform fee schedule, or guaranteed availability of all services has not been established. Universal Health Coverage (Couverture Maladie Universelle) is administered by the IPS-CNAM institution (Institution IPS-CNAM). For the contributory RGB scheme (RGB), the contribution is 1,000 FCFA per person per month; the contribution-free RAM benefit (RAM) is a CMU service for people in need. Registration, the card, covered services, the co-payment, and the facility’s contract status should be checked locally and currently. CMU guarantees neither medicine supplies nor available specialists or short waiting times. In French-influenced administrative and medical language, terms such as centre de santé, district sanitaire, maternité, and CHU can help with searches. Users can ask about available services, fees, prescriptions, referrals, and expected waiting times and should keep their health records. They should follow prescriptions and return instructions; authorized providers need licensed staff, hygienic procedures, regulated medical-waste disposal, and compliant medicine supply.