Health Systems Strengthening in West Afric

Since the 1980s, West African countries, and particularly Ivory Coast, Liberia and Sierra Leone, have been affected by violent conflicts, natural disasters and large-scale epidemics.

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.