Despite strong economic growth, Ivory Coast still struggles with pervasive poverty and inequity: approximately 46 percent of the Ivorian population live below the national poverty line with more than half living in rural areas. With Ivory Coast’s middle-income status, the country’s health profile is comparable to a low-income country and its health outcomes are amongst the poorest in the region. Life expectancy is 55, which is one of the lowest in the world.
The GFF Partnership Response
The GFF partnership is supporting the government of the Ivory Coast in improving equity and efficiency in service delivery and financing, engaging the private sector, collaborating with civil society, and coordinating donor support. The country’s investment case, 2016-2020 National Health Development Plan aims to increase the health budget by 15 percent a year and guide resource allocation to priority investments in primary health care, benefiting populations with the most pressing needs. The investment case focuses on “best-buys” –evidence-based, high-impact interventions – that will achieve health outcomes in an equitable and efficient manner. An increase in public health spending on primary health care includes community health services,a nationwide scale-up of strategic purchasing, linking of the universal health insurance scheme,and involving private sector service providers in strategic purchasing reforms through regulation, accreditation, and contracting mechanisms. The GFF is also co-financing the World Bank health project, SPARK.
The Ministry of Health and Public Hygiene has launched several reforms and initiatives to mobilize additional resources and improve public financial management in health. Reforms focus on expanding protection of financial risk through a national health insurance scheme; increasing access to quality maternal and child services with critical medicines and supplies; and strengthening health sector governance. Under the Investment case success will be measured based on increased public spending on primary care to improve service coverage of a basic package of services and a reduction in maternal and infant mortality. The government is also working with the GFF, the Global Fund and UHC2030 on strengthening CSO capacity to engage in health financing dialogue and effective advocacy for increased and more efficient domestic health spending. In addition, a private sector assessment supported by the GFF has identified key gaps in regulations and systems to be addressed through the investment case and the World Bank project.