© Côte d'Ivoire

Ivory Coast

9.8%

of people who use drugs in Abidjan have tuberculosis

5.4%

people who use drugs in Abidjan are HIV positive

2

women die every 3 hours from problems linked to childbirth

The situation in Ivory Coast

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

Women & children

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.

En 2019

Nous avons :

  • organisé 11 sessions de formation des acteurs locaux sur les droits à la SSRinfo-icon
  • appuyé la réalisation de 26 consultations foraines 
  • informé 29 239 jeunes et adolescents sur leurs droits en SSRinfo-icon
  • sensibilisé plus de 8 497 jeunes et adolescents sur la SSRinfo-icon
  • identifié 35 jeunes « ambassadeurs » locaux
  • apporté un accompagnement psychosocial à 203 jeunes vulnérables

 

 

© Sebastien Duijndam
© Sebastien Duijndam
Pregnant women in the waiting room of a health centre run by Doctors of the World. © Sébastien Duijndam
Pregnant women in the waiting room of a health centre run by Doctors of the World. © Sébastien Duijndam

At-risk people

Caring for prople who use drugs

 

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).

 

In 2019

We:

  • raised awareness among 12,323 people who use drugs through peer educators
  • saw 11,140 people who use drugs for consultations, including 792 women
  • distributed 66,852 condoms and carried out 8,003 HIV tests
  • trained 301 medical staff and community workers
  • supported 33 female drug users through their pregnancies and up to giving birth

 

our institutional support

Initiative 5%, financée par le ministère français des Affaires étrangères soutient Médecins du Monde
Le Fonds mondial de lutte contre le sida, la tuberculose et le paludisme soutient Médecins du Monde
History
2011
4-month emergency intervention in Abidjan following the post-election crisis.
2011
Project providing support in obstetric emergencies in the south-west of the country.
2012
Partnership for transition – support for targeted free care in the south-west of the country.
2014
Study among people who use drugs in Abidjan.
2014
Project to strengthen the Ivorian healthcare system.
2014
Preparation of a response to the Ebola epidemic in the south-west of the country.
2015
Opening of a programme for people who use drugs in Abidjan.
2016
Study of the socio-cultural determinants of unwanted pregnancy among young people.
2017
Community study of the prevalence of tuberculosis and associated factors among people who use drugs in Abidjan.
2017
Project for the prevention and treatment of unwanted pregnancy among young people in schools in Soubré.
2019
Second phase of the harm reduction programme for people who use drugs in Abidjan and opening of the Addiction Treatment and Counselling (CASA)

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