In the aftermath of the post-election violence in Cote d’Ivoire, President Alassane Ouattara made a pledge to provide free healthcare temporarily in order to accelerate the recovery of a population emerging from months of chaos and violence. Typically, Cote d’Ivoire has enforced a cash recovery (or user-fee) policy in the provision of medical services, an approach that has been long debated in health, economic and development communities.
In a country with a population of 21 million and 1.4 Doctors and 4.8 Nurses or health workers / 10,000 population, it is clear that not everyone will be able to access or benefit from this brief window of universal access. Further compounding the challenge of meeting the current health needs in Cote d’Ivoire are stock outs of supplies and pharmaceuticals, partially a result or sanctions imposed during the conflict, and the displacement of health workers. According to UN reports, many health workers fled Abidjan during the conflict and have yet to return, while those practicing are experiencing a two-fold increase in the number of patients they see per day.
Whether user-fees have been the largest barrier to accessing healthcare in the country remains up for debate, but it is obvious that the health system as it is currently structured will not be able to provide universal access to healthcare sustainably for any length of time. Analysts point to the need for supply side reforms, adjusting taxation and insurance mechanisms, and broader institutional reforms addressing quality, management and accountability. In addition to these structural reforms, is there an opportunity to integrate mHealth solutions to help alleviate the pressure the current system faces and improve access for citizens over the longer term?
What impact could mHealth tools such as MDNet (rolled out in Ghana and Liberia) which connects health professionals and Doctors to improve the transfer of medical knowledge, referral process and improve access to specialists in remote areas have in addressing the health worker shortage in Cote d’Ivoire? Is there a role for Sproxil’s mPedigree to ensure that drugs are authentic following the stock outs and supply problems experienced during the conflict? How could Voxiva’s TracNet be used to strengthen the Health Information Management System (HIMS) and share patient and drug information following the displacement of large numbers of the population? There is much to be learnt from the implementation of mHealth services in other countries, and the replication of successful initiatives in Cote d’Ivoire may present new opportunities to extend health services.
The innovative application of mobile health in post-conflict settings has the potential to offset costs, improve access and support Government initiatives to meet the immediate health needs of communities recovering from violence and an interruption in their regular health seeking behaviour. Are there particular mHealth implementations or solutions that you think could make a difference in the delivery of healthcare in Cote d’Ivoire?

Kyla Reid, Knowledge Manager, GSMA Mobile Health Programme