Complex circumstances hamper progress reducing maternal mortality in Côte D’Ivoire.
Like most under-developed countries reducing maternal mortality in Côte D’Ivoire is not a simple or straightforward task. Thankfully some progress is being made.
The West African nation of Côte d’Ivoire is slowly recovering from instability and conflict which has divided the nation along North-South lines. The outbreak of civil war in 2002 had worked to reverse many of the advances made in maternal health over the previous decade. While nearly 70% of births were attended by trained personnel in 2004, this dropped to 57% in 2006. The maternal mortality ratio has gratefully dropped from 710 deaths per 100,000 live births in 1990 to 400 in 2010 ((WHO)), but improvements have been uneven, with over 95% of the richest quintile receiving antenatal care and skilled birth attendance, as compared to just 20% of the lowest quintile. Other indicators of maternal and child health, like exclusive breastfeeding and access to malaria treatment, have also been stunted by Côte d’Ivoire’s civil strife ((“Countdown to 2015: Maternal, Newborn and Child Survival,” 2012)).
The government of Côte d’Ivoire announced a programme of free maternal and newborn care in 2010 as an intended boost to moribund health figures. This proved to dramatically increase the demand for services among women, but the system of care has faltered under the weight of increased patient numbers. Chronic staff shortages, with just 103 obstetricians and 2,500 midwives for a population of over 21 million, means that while more and more women are attending facilities, the health structure is unable to provide the necessary care ((“State of the World’s Midwifery,” 2011)).
Côte d’Ivoire has set itself ambitious goals to improve the situation for its mothers, but the nation is struggling under the weight of political uncertainty. The health system has not recovered from years of conflict and instability, as both the training and employment of skilled health professionals have been halted. Policies to improve access to care have not been met with significant improvements in infrastructure development, leaving women with little chance to receive the quality services so desperately needed in pregnancy and parturition.
In addition to direct health care access concerns, there are also several other impediments to reducing maternal mortality in Côte d’Ivoire. The national committee on health care through the UN CEDAW report notes that sexual violence and lack of access to contraceptions also contribute to higher mortality rates ((Cote d’Ivoire Government, Convention on the Elimination of All Forms of Discrimination against Women, 18 October, 2010, 10 March, 2012, 65, 66, 68)).
Several programs have been developed with the help of the UN, WHO, UNICEF, World Bank, The European Union, The African Union and many others to help provide the necessary financing and expertise to begin to address some of these concerns ((UNICEF)).