Trends in reproductive and maternal healthcare indicators, Côte d'Ivoire, 2018 to 2020.

Abstract

Background: Despite some improvement, there are still persistent challenges in the area of reproductive and maternal health in Côte d'Ivoire.

Aim: Analysing subnational trends of key indicators of reproductive and maternal healthcare from 2018 to 2020, regarding the targets of the investment case of 2023.

Setting: All 33 health regions and 113 health districts (HDs).

Methods: The analysis was concerned with four indicators: the modern contraceptive prevalence rate (mCPR), the proportion of first antenatal care (ANC1) during the first trimester, the coverage of four antenatal care (ANC4), and the coverage of delivery with a skilled birth attendant (SBA). Using data from the national health information system, we analysed the evolutive trends of each indicator at district level, assessed the performance regarding the 2023 targets, and identified the disparities at districts and regions level. Data were processed using Microsoft Excel, QGIS 3.16 and Stata 15.0 software.

Results: There was a lack of significant progress for mCPR and ANC1 during the first trimester. In 2020, more than two out of three of the HDs were still far from the 2023 target for both indicators. In contrast, there was a clear progression for ANC4 and SBA, with more than 40% of districts having already reached the 2023 target. These evolutive trends were associated with high disparities across HDs and regions.

Conclusion: In spite of positive evolutive trends for some indicators, there are still high disparities at subnational levels.

Contribution: Interventions need to be fully implemented, and progress monitoring should be reinforced and pursued for timely adjustments.