Child and Maternal Mortality
in Islamic Countries
113
3.3.4. Lessons learned from Côte d’Ivoire
Despite a strong commitment at different levels including from the Head of the state in Côte
d'Ivoire, the country has made little progress in reducing maternal and neonatal mortality. The
maternal mortality rate was reported at 617 per 100,000 live births in 2017. Over the last 25
years, the country was able to reduce MMR by 13.4% compared to 44% reduction globally.
There was progress in the reduction of the under-5 mortality rate but less progress was seen
with the neonatal mortality rate. Although the utilization of skilled birth attendants was
estimated at 59% in 2012, the rate was much lower among the poor. The total fertility rate was
high at 5.1 in 2015.
Poor perceived quality of care was one of the biggest barriers noted by the Key Informants in
Côte d'Ivoire, especially poor quality of services, poor reception extortion, racketing,
overcharging. Another complaint was the persistence of harmful socio-cultural practices by
traditional birth attendants for delivery with poor quality of services. Essential medicines and
other commodities are not available most of the time. There is no such protocol or guidelines for
management including a low level of technical skills in the management of EmONCs (Emergency
Obstetric and Neonatal Care).
According to the Key Informants, there is an insufficient and uneven distribution of health
personnel in general and there is inadequately trained personnel for EmONC. There seems to be
a lack of trained gynecologists and midwives including urban/rural disparities in the health
workforce.
Another challenge that was mentioned by the key informants was insufficient funds allocated to
the health sector in general and maternal health in particular for the subsiding EmONCs and the
purchase of medicines.