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Ivory Coast: removing financial barriers for pregnant women
Directed by Sébastien Duijndam
Since 2012 in Ivory Coast, access to healthcare is free of charge for pregnant women and children under the age of 5.
But barriers still exist that prevent the actual implementation of this policy.
In the Bas-Sassandra region, MdM supports 30 maternity clinics and health centres
with the renovation of the facilities and drugs and medical supplies.
Her hips hurt, and often her feet too. Often she goes to hospital and the maternity unit
gives her a prescription but she cannot afford to buy all the medicines.
Health workers receive training for the medical follow-up of pregnancies and for the care and treatment of the related complications.
MdM also works to reinforce the capacities of 3 hospitals to manage obstetrical emergencies.
The definition of *** and reproductive health is very much associated with the healthof a woman in general throughout her whole life.
When we talk about continuum of care it is really about supporting the health of the person during their whole life.
And in the particular case of pregnancy which is an important event but not the only one, there are other important events,
it is the fact of accompanying the person from the moment she decides to have a child – but also includes infertility treatment,
access to contraception, access to pregnancy healthcare, delivery by qualified personnel and post-natal care.
We have noted that women have better prenatal health coverage, which is done essentially for prevention,
because to come to a pre-natal consultation is relatively easy since there is no fixed appointment or date.
MdM supports the teams in their financial annual planning in order to make sure that healthcare is effectively free of charge.
Actions are organised so as the national and local actors give more support to this national policy.
When a pregnant woman arrives, we take her temperature, blood pressure and weight.
And we also vaccinate her during the same visit.
While she sits on the bench, at the same time we take the opportunity to raise awareness about ***/Aids and encourage her to get tested.
We have seen that women tend to come to the healthcare centre less for delivery than for pre-natal consultation.
This is due firstly to the unpredictability factor, and then there is the element of cost for the person,
with all the difficulties of obtaining the necessary transportation, healthcare and medication.
There is also the fact that women have less access to the financial resources, which requires the husband’s consent,
and so there are many barriers that can potentially stand in the way of a woman’s wish to give birth in a medical environment.
The maternity unit has the highest rate of all patient attendance and activity;
the highest number of deliveries and antenatal care consultations.
That’s why we have these tables here for the maternity. These two new tables were given
because the others were inadequate and worn out because of the high attendance.
We provided the means to support them in terms of facilities and medicines.
When it comes to pregnant women, we face multiple barriers. The first concerns the decision
and the possibility for her to access a healthcare centre that carries out deliveries under the proper conditions.
She says her name is Fofana Fanta
She needs to make an appointment but she cannot afford to make an appointment.
Between 1990 and 2005 there were around 550 000 woman who died every year following a pregnancy.
This figure remained steady and then from 2005 we noticed an improvement in these figures, which is great news.
There is also a greater awareness in the national policies which have now started to bear fruit
and we have seen maternal mortality figures decrease significantly since 2005 and real progress over the past four or five years.
This should be acknowledged as a real achievement even though it is not enough.
Countries with a relatively high maternal mortality rate have tried to put in place
measures that are very operational, whether that be training midwife, lifting financial barriers
or supporting a healthcare system and this is beginning to achieve good results.
I think what is really important for us is to have an approach based both on human rights and healthcare,
this is the case in all our projects but it seems to me particularly visible regarding the issue of women.
If we didn’t have Médecins du Monde here, we would not be able to support the needs of women in terms of provision of medicines and treatment.
Esther Midwife [script on screen]
Without them it would have been very difficult. Before there was sometimes a medicine shortage
but thanks to them there hasn’t been any until now, and I really want to thank them for that.
More than 20,000 pregnant women and 58,000 children of this region have access to free healthcare thanks to the policy supported by MdM.
Directed by Sébastien Duijndam March 2013