Côte d'Ivoire is abandoning free health care for all after a brief experiment because of skyrocketing costs.
“In nine months the government had to pay 30 billion CFA francs [about US$60 million] under difficult circumstances," Ivoirian Health Minister Yoman N'dri said in Abidjan on 24 January.
As of February, the free service would only be available to mothers and their children. Specifically, this will mean free care for deliveries and free treatment for diseases affecting children under six years old. Consultation fees would drop from 1,000 CFA francs to 650 francs CFA ($2-1.5).
Aid organizations say the government move is understandable given the country’s recent political turmoil. "As long as women and children continue to receive care we are satisfied because they are among the most vulnerable," said Louis Vigneault-Dubois, head of communications for the UN Children’s Fund (UNICEF) in Côte d'Ivoire.
"Women and children are often exposed to diseases and with so many families living in poverty this is already a major problem solved for them,” said Zana Sanogo, executive director of Community Health and Development, a local NGO collaborating with the UN Office for the Coordination of Humanitarian Affairs.
Theft, poor management and rising costs have made the service - introduced by President Alassane Ouattara’s government at the end of civil conflict to ease a dire public health situation - unaffordable.
Health Minister N’dri said implementation of the service had been poorly planned, and the Public Health Pharmacy, the state’s central body for distribution of medical supplies throughout the country, had just 30 percent of its required stock, much of which had been pilfered.
"From the start some nurses and doctors, under the pretext of providing free health care, had been taking drugs home which they would then sell,” said Florantin Yao, staff nurse at the government-run Port-Bouët General Hospital in the south of Abidjan.
The Ministry of Health says 20 doctors and nurses have been “severely punished”. One received a two-year prison term.
Community health analyst and consultant Issouf Ouattara said free health care would have been more viable had health authorities spellt out details of the policy. "We fear that practitioners and patients continue to misunderstand the free health care policy. Medical consultation and drugs should be free,” he added.