Cote d’Ivoire

Cote d’Ivoire is a coastal country in West Africa known for its status as an economic powerhouse in the region as well as for its civil wars and political turmoil over the past decade. Cote d’Ivoire comprises 40 percent of GDP for the West African Economic and Monetary Union (WAEMU), making its viability crucial to that of the entire subregion. A civil war in 2002-03 and a post-election civil war in April 2011 have posed obstacles to the country’s economy and political stability. 

Ivoirians face a significant risk of contracting HIV/AIDS. With an estimated adult prevalence rate of 3.0 percent in 2011, Cote d’Ivoire is one of West Africa’s most affected countries.  The disease’s impact varies regionally, with rates increasing from North to South and along the eastern and western borders. As in many sub-Saharan African countries, women are disproportionately affected by the virus. Groups most at-risk of becoming infected include sex workers and their partners and clients, men who have sex with men and injecting drug users.   

MEASURE Evaluation in Cote d’Ivoire

MEASURE Evaluation has maintained an in-country office in Cote d’Ivoire since 2004. Activities focus on strengthening health information systems and training health and government professionals in M&E. MEASURE Evaluation collaborates with three government ministries in the country:

• The Ministry of Health and Fight Against Aids (formerly two separate ministries)
• The Ministry of Education
• The Ministry of Woman, Family and Infant (formerly named The Ministry of Family and Social Affairs)

A sense of partnership toward the common goal of creating an integrated system that provides high-quality data to decision makers reverberates throughout all of MEASURE Evaluation’s activities in the country.  

Strengthening the HMIS Reporting System

Strengthening its national health monitoring information system (HMIS) has been a top priority for Cote d’Ivoire. The stronger the overall information system, the better equipped organizations will be for monitoring and evaluating their own health programs.

In 2008, MEASURE Evaluation began assisting CATSIS, a group dedicated to district-level data collection and management. “We helped CATSIS through day-to-day capacity building in data management,” explained Leontine Gnassou, MEASURE Evaluation’s Resident Advisor in Cote d’Ivoire.  “Today, they are able to independently conduct supportive supervision and collect monthly reports from the districts.”

During Phase III, MEASURE Evaluation has continued its work with CATSIS by administering software development training for the Management Tool for Electronic Patient Files (SIGDEP), a national HIV patient monitoring system. MEASURE Evaluation also helped to improve the HIV patient monitoring tool to include management of antiretroviral therapy (ART) drugs and a pharmacy module. 

Working with the Ministry of Health and Fight Against AIDS

MEASURE Evaluation’s ongoing work with the Cote d’Ivoire Ministry of Health and Fight Against AIDS has been an essential component in strengthening the country’s HMIS. Highlights of MEASURE Evaluation’s support include:

• Providing M&E training courses for staff members at the National Training Institute and the National School of Statistics and Applied Economics
• Developing a data management procedures manual to improve data quality
• Organizing routine data quality assessments (RDQA) with staff members from all 19 Regional Health Directorates to enable data quality self-assessment 
• Implementing a Monitoring Reporting System to improve HIV non-health data reporting
• Conducting a trend analysis to review available HIV data and identify research priorities for HIV/AIDS organizations (the analysis identified most at-risk populations as a priority target for country’s National HIV Strategic Plan)
• Coordinating leadership development workshops 
• Developing a national database with web access for SIGDEP

“All of these accomplishments are really important for the Ministry of Health and partners,” said Gnassou. “Now they can rely on a working and efficient information system for better health sector planning, especially in the area of HIV/AIDS.”

Improving OVC Data with the Ministry of Woman, Family and Infant

Cote d’Ivoire’s Ministry of Woman, Family and Infant oversees the country’s response to children orphaned or made vulnerable by HIV/AIDS, through the National OVC (Orphaned and Vulnerable Children) Program.  

MEASURE Evaluation has worked with this ministry to improve the OVC M&E reporting system by:

• Revising OVC data collection tools
• Developing an OVC database in collaboration with CDC-Cote d’Ivoire
• Training the National OVC Program M&E staff members in database use and management
• Conducting an assessment using the Monitoring and Evaluation Systems Strengthening Tool (MESST) 
• Mapping OVC data for use in managerial decision making 
• Developing an OVC data management procedures manual
• Partnering with the National Training Institution of Social Workers to develop an M&E course as part of the Institution’s training program

“These accomplishments are significant because the M&E capacity of the National OVC Program has been built,” said Gnassou.  “Now there is real ownership of the OVC data-reporting process.”

After several years of capacity building activities, OVC database training is now done by local M&E managers, with very little assistance from MEASURE Evaluation.

Assessing Information Systems in the Ministry of Education

The Ministry of Education is responsible for implementing and reporting all HIV prevention activities in Cote d’Ivoire’s education sector. To support this effort, MEASURE Evaluation helped assess the informatics environment of the Ministry’s regional directorates.  

Findings from the assessment were used to develop a systems strengthening plan for HIV data reporting. Internet connections were provided to twelve ministry regions and the HIV data transmission between the regional directorates and central level improved – from between 10 and 70 percent completeness to between and 70 and 100 percent.

MEASURE Evaluation also helped the ministry to revise data collection tools, develop a data management procedures manual, and to coordinate meetings and workshops to encourage members to share experiences about improving data use.

Read more about MEASURE Evaluation’s role in facilitating collaboration among the different government ministries in Cote d’Ivoire.