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Action contre la Faim - Sierra Leone © action against hunger



Health Systems Strengthening in West Afric

Although the three countries had been enjoying relative stability since the end of the Ebola epidemic (2014-2016), those numerous shocks have undermined public services, which are now struggling to meet the needs of the population, particularly in terms of healthcare.

With the support of the Agence Française de Développement (AFD), the PROSSAN project implemented by Action contre la Faim aims to strengthen the health systems of these three countries, and to put women and young people at the heart of the decision-making process regarding their health.


The state of health services


The national indicators are particularly revealing of the weakness of health services, and the precariousness in which women, their children and young people find themselves. For all three countries, child mortality rates are high. Sierra Leone has the second highest child mortality rate in the world.

In the area of nutrition, the three countries also fail to meet the World Health Assembly targets for acute and chronic malnutrition.

Women in the region are particularly vulnerable during pregnancy and childbirth. Maternal mortality rates are also very high, due in part to the fact that between 26% and 40% of deliveries are not attended by skilled health personnel. Finally, young girls are particularly vulnerable to early marriage and pregnancy.

Very high poverty rates – between 46% and 60% of the population – and high unemployment among women and young people largely explain this alarming situation. This precariousness makes their access to health care services more limited, even though they are the ones who need attentive listening and specific services.

Action contre la Faim - Côte d'Ivoire (2) © Action against Hunger

Côte d'Ivoire Santé

© Action against Hunger

Action contre la Faim - Côte d'Ivoire © Action against Hunger

Côte d'Ivoire Santé

© Action against Hunger

Action contre la Faim - Côte d'Ivoire (3) © Action against Hunger

© Action against Hunger



Providing quality care adapted to women and young people


The PROSSAN project contributes to improving the health of vulnerable populations in Ivory Coast, Sierra Leone and Liberia, particularly women, children under five and young people, by providing quality care adapted to their specific needs. Its aim is to reduce the number of early pregnancies and the number of maternal and infant deaths in the health areas.


The project’s approach stands on three pillars

  • Supporting health authorities, health facility staff and community health workers to provide quality services. The objective is not to substitute but to build capacity and establish good practices for a better-functioning system.
  • Mobilizing communities and Civil Society Organisations to empower women and young people to take responsibility for their own health and that of their children, in order to improve health-related behavior.
  • Strengthening advocacy at all levels to bring about change or enforcement of laws and policy commitments for the health of the project’s target populations.

The intervention also aims to meet the Sustainable Development Goals (SDGs) to which the three countries are committed and in particular SDG 3 (Good Health and Well-being) to enable all people to live in good health and to promote the well-being of all people at all ages ; SDG 5 (Gender Equality) aiming to achieve gender equality and empower all women and girls; SDG 16 (Peace, Justice and Effective Institutions) in that it will encourage effective health authorities, participation and representation in decision-making and the promotion and enforcement of non-discriminatory laws and policies; and finally SDG 2 (Zero Hunger) on the elimination of hunger through activities to prevent and treat undernutrition, including chronic malnutrition.


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