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Political Crisis in Côte d’Ivoire Hampers Access to Health Care Services

Continuing political unrest in Côte d’Ivoire is impeding efforts to expand access to health services, including EngenderHealth’s initiatives to improve the quality of HIV and AIDS care for Ivorian women, men, and families.

For nearly three years, EngenderHealth has worked in Côte d’Ivoire to improve the health of individuals by preventing the spread of HIV and reducing unwanted pregnancies. With our partners—the Association Ivoirienne pour le Bien-Être Familial (AIBEF), the Elizabeth Glaser Pediatric AIDS Foundation, the Centers for Disease Control and Prevention, and others—EngenderHealth focuses on integrating family planning with HIV and AIDS services, including the prevention of mother-to-child transmission of HIV. The program also helps create gender norms that promote healthy sexual behavior while encouraging men to accompany their partners to health facilities. At the policy level, our program staff has assisted in developing national guidelines to include family planning messages in antenatal care, to ensure that new mothers have access to contraceptives.

“By the fall of 2010, the work in Côte d’Ivoire was making important headway in improving the quality of health clinics and reaching out to Ivorian communities about HIV and family planning services,” said John Yanulis, Senior Technical Advisor for EngenderHealth’s RESPOND Project. But the political crisis since then has hampered progress. As a result of postelection unrest since November, more than 200 people have died, and sexual violence against women has increased. Insecurity has affected Ivorians’ use of and access to health services. Prospects for violent conflict threaten to reverse important health care gains made in the country, where HIV prevalence is among the highest in West Africa.

Today, EngenderHealth works out of an office in Abidjan but has supported program activity in the cities of San Pedro and Daloa in the southern half of the country, as well as in areas across central Côte d’Ivoire. While deteriorating security conditions have disrupted EngenderHealth’s program activities, they have not stopped the staff members from going to the Abidjan office every day, said Dr. Madeleine Sassan Morokro, Program Manager for the EngenderHealth/RESPOND project there. But the absence of public transportation and the danger of riots and violence have made daily tasks, such as traveling to meetings, increasingly challenging. Several program events have been canceled, along with planned visits by technical experts. Some northern suburbs of Abidjan, including Anyama and Abobo, are currently subject to government curfew because of recent unrest, though this has not directly affected EngenderHealth staff in Abidjan.

To date, the Global Fund to Fight AIDS, Tuberculosis and Malaria has suspended all contracts and activity in the country. Programs under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the U.S. Agency for International Development continue to operate, though at reduced levels. EngenderHealth continues to monitor the crisis and will keep our supporters apprised of the effects of ongoing instability on program activities.

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