Providing healthcare and advice in remote villages

“When the project began, in some villages I met patients who had never visited a health centre, women without health records, and even some people who had never even heard of a nearby health centre. Some nurses or midwives had never travelled more than 5km before,” says Yao Marie Cécile Victoire, a midwife and deputy head of the maternal and child health component of the ACT-Femmes project. 

Since 2021, in three departments in northern Côte d’Ivoire – Ferkessédougou, Kong and Ouangolodougou – Action Against Hunger teams have been implementing the Empowerment of Women and Adolescents in the Tchologo Communities (ACT-Femmes) project, funded by Global Affairs Canada. Although Côte d’Ivoire is now a country with strong economic performance, regional disparities persist and the north accounts for the bulk of humanitarian needs. Gender inequalities remain significant, and indicators relating to sexual and reproductive health and rights highlight major challenges for Ivorian women. According to the Demographic and Health Survey (EDS-CI), the maternal mortality rate stands at 385 deaths per 100,000 live births. It is also estimated that 37% of women aged 15 to 49 have undergone female genital mutilation and that one in two women uses a modern method of contraception. 

“Twice a month, we take the mobile health clinic to a village to provide quality care. What’s new with the ACT-Femmes project is that we’ve integrated legal advice – provided by our partner, the Association of Women Lawyers of Côte d’Ivoire – and mental health care into our services, so we can offer these to the local communities,” explains Yao Marie Cécile Victoire. 

In practice, over the course of half a day, several stands are set up to welcome, free of charge and on a joint basis, residents from the village and the surrounding area. In collaboration with the department’s Social Centre, these gatherings—where people may travel from villages dozens of kilometres away, or even from neighbouring countries, to access these services—provide an opportunity to organise group awareness-raising sessions alongside health consultations.  

For example, in the village of Korodiala, in the Kong department, teams organised an awareness-raising and discussion session on forced marriages involving minors. Although these practices are prohibited by law, just like female genital mutilation, they remain widespread in the region, where many communities, whether sedentary or nomadic, continue to practice them. These sessions provide an opportunity to explain the medical and legal consequences of such practices for women and girls. 

At the maternal and child health stand, healthcare workers provide information and advice to women on childbirth, the importance of antenatal check-ups and family planning, to help them plan their pregnancies more effectively. Discussions between mothers and daughters are encouraged so that they can talk together about unwanted pregnancies and thus better avoid them. Pregnant women who have missed their check-up appointments can also seek advice. 

“I had an appointment this month at the hospital for my pregnancy. Last night, my husband and I spoke about it again. Today, we’ve come to listen to the discussions with the health workers and take part in consultations if any are available. When they come, we make the most of the opportunity to listen to their advice, seek a consultation or discuss any health issues we may have. This morning, I was lucky enough to wake up in good health,” says Ouattara Adja, a young mother.  

For children aged 0 to 5, a major catch-up vaccination programme is on offer – BCG, hepatitis A, DTP-polio, measles, yellow fever, vitamin A supplementation, pneumonia… covering 11 conditions, including the new malaria vaccine. At the nutrition stand, mothers receive information and advice on cooking with three food groups to ensure their children are well-nourished and healthy. General medical consultations are also available, and for those showing certain symptoms of malaria, patients will be tested and treated free of charge. For other conditions, patients will be referred to the nearest health centre. Finally, individual counselling sessions are also offered for those in need of mental health care. 

“We have already carried out these activities in around a hundred localities. I am very proud of the work we have done. The diagnoses we have made have enabled us to identify and treat certain conditions at an early stage. The vaccination campaigns help to protect the youngest children.  We are saving lives through our presence,” concludes Yao Marie Cécile Victoire. 

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The ACT-Femmes project, funded by the Government of Canada, aims to empower women and adolescent girls and help them gain autonomy by improving their access to health services, safeguarding their rights and encouraging their involvement in family and community decision-making. It also promotes women’s financial independence, notably by supporting the establishment of income-generating activities and literacy courses. To combat gender-based violence, awareness-raising sessions are organised regularly with the Association of Women Lawyers, which also supports victims of such violence.   

The ACT-Femmes project aims to empower women and adolescent girls and help them become more independent by improving their access to healthcare services, safeguarding their rights and encouraging their involvement in family and community decision-making. Financial independence is one of the key factors in achieving this.  

55 VSLA (Village Saving and Loan Association) groups, including 33 set up with direct support from Action Against Hunger and 22 groups spontaneously initiated by the communities, are supported and monitored as part of this project. The organisation of community awareness-raising sessions has reached over 90,000 people.