of people who use drugs in Abidjan have tuberculosis
people who use drugs in Abidjan are HIV positive
women die every 3 hours from problems linked to childbirth
Unsafe sexual behaviour among young people
Ivory Coast records a maternal mortality rate of 614 deaths per 100,000 live births, of which 15% are due to complications following unsafe abortions. Only just over half of teenagers (55%) use any method contraception during their first experience of sexual intercourse (mainly male condoms).
Poor access to contraception drives up teenage pregnancy rates
There are still many barriers to accessing good sexual and reproductive healthcare, in particular the absence of a legislative framework for SRH (the current law dates from 1920), the lack of funding for contraceptive products and disruptions to supplies.
30% of girls in Soubré who are sexually active use 'a modern' method of contraception
At national level, only 30% of young people use contraception. As a result, many pregnancies are recorded every year among young people of primary and secondary school age. This leads to high levels of abortions (75% according to a study carried out in schools in 2018). Yet the law in Ivory Coast remains very restrictive on abortion and healthcare staff are not trained in how to manage unwanted pregnancies. This encourages women and girls to seek unsafe abortions.
HIV Aids, hepatitis and tuberculosis: high prevalence of infectious desease in Ivory Coast
As a medical NGO active in Ivory Coast, Médecins du Monde conducted a study in Abidjan in 2014 among 450 regular users of cocaine, heroin and crack cocaine. The study showed that people who use drugs are vulnerable and at risk of infectious disease due to their unsafe sexual behaviour, drug use and extremely precarious living conditions. They are stigmatised and often live in rundown areas with no access to water or sanitation.
The level of HIV infection is particularly high in this group, especially among sex workers (HIV prevalence in people who use drugs and sex workers is 22.5%). In addition to HIV, the prevalence of tuberculosis is much higher than in the general population (9.8% compared to 0.2% at national level) which leads to significant numbers of cases of HIV / tuberculosis co-infection. Furthermore, 10% of people who use drugs are hepatitis B carriers.
Our activities in Ivory Coast
young people and Sexual and reproductive health
The study carried out by Médecins du Monde in 2016 on the sociocultural determinants of unwanted pregnancy revealed that the sexual and reproductive health services available for young people are not tailored to their needs. Lack of knowledge about their rights, lack of money and the fact that such services run counter to the values and beliefs prevalent in their social environment mean young people don’t use these services.
Preventing and managing unwanted pregnancies
Since mid-2017, Médecins du Monde has supported the public healthcare system through a project which uses a rights-based approach and aims to improve prevention and management of unwanted pregnancies among young people in Soubré (in the west of the country).
Data from a study conducted in April 2019 show that 30% of girls who are sexually active use a ‘modern’ method of contraception, of whom 81% were using male condoms. In addition, 10.3% of girls interviewed for another survey had been pregnant at least once and 36.4% of pregnancies were terminated through abortion (40% of these at private clinics).
In an effort to find solutions to the issue of access to family planning services for women and girls, Médecins du Monde is supporting advocacy activities at the national level and is working with local and international actors to secure funding for and distribution of family planning supplies.
Since January 2015, Médecins du Monde and its local humanitarian organisation partners have been running prevention and harm reduction activities for people who use drugs in Abidjan, with the aim of improving the way they are treated by the healthcare system.
Médecins du Monde is working to build these individuals’ capacity to act in order to develop appropriate responses and combat the stigmatisation, exclusion and criminalisation which represent barriers to accessing care.
The second phase of this project, launched in 2018, led to the opening in August 2019 of an Addiction Treatment and Counselling Centre (CASA) which provides holistic treatment and support for people who use drugs. The CASA currently offers a package of different services, including facilities for washing and laundry, places to rest, information and awareness-raising, distribution of harm reduction tools, screening and testing, medical consultations, welfare support, psychological treatment and community activities, alongside outreach work (HIV testing, primary healthcare and referrals).
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