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Côte d’Ivoire, a country of 18 million people, is one of the world’s largest producers and exporters of coffee, cocoa beans, and palm oil. Per capita income averages $870. Beginning in 1999, the former French colony experienced years of political turmoil that resulted in violence, internal displacement, and economic downturn. In 2007, the civil war ended with the signing of a peace agreement.
Over the last decade, as a result of the civil war, the health care system has deteriorated and has been unable to meet the basic health needs of the majority of its population, with chronic shortages of equipment, medicine, and health care personnel. Life expectancy averages 44 years of age, with HIV/AIDS and malaria as the leading causes of death. Almost half of women do not deliver their babies in health facilities, which heightens the risk of maternal and neonatal death. Only 13 percent of women used any form of modern contraception to space or limit births. (2011, preliminary DHS)
Côte d’Ivoire has an adult HIV seroprevalence of 4.7 percent one of the highest in West Africa, with 750,000 people living with HIV in the country. Despite a national coordinated response to HIV beginning in 2001, political unrest has prevented the scale up of HIV services. Only an estimated 50,000 people are currently receiving antiretroviral therapy (ART), and services for the prevention of mother-to-child transmission (PMTCT) of HIV reach a limited number of women.
ICAP in Côte d’Ivoire
In 2002, ICAP began supporting family-focused, multidisciplinary HIV prevention, care, and treatment services at two health facilities in the capital, Abidjan, in partnership with ACONDA, a local non-governmental organization. Since 2007, with new support from the U.S. Centers for Disease Control and Prevention under the President’s Emergency Plan for AIDS Relief, ICAP expanded its activities to additional health facilities in five regions in the central/west part of the country. In partnership with the Ministry of Health, ICAP has been supporting the capacity of districts to provide the full range of comprehensive HIV services, including:
- Pediatric and adult HIV care and treatment, including provision of ART
- Integrated tuberculosis/HIV care and treatment
- Rapid HIV testing for adults and children
- Diagnostic testing/analysis, including Dried Blood Spot DNA PCR testing for infants
- Training programs for all cadres of healthcare providers in HIV/AIDS prevention, care, and treatment
- Community outreach
- HIV support groups, including medication and treatment adherence
- Peer education programs
More recently, ICAP in Côte d’Ivoire has built the capacity of a local NGO to support HIV prevention, care, and treatment programs in some of these regions, while continuing to directly support services in the other regions. In addition, ICAP in Côte d’Ivoire increasingly is focusing on operational research and capacity building for nursing cadres.