HIV/AIDS, lagging policy response and impact on children: the case of Côte d’Ivoire

This study reviews the experience of Côte d'Ivoire in dealing with the HIV/AIDS epidemic and pays special attention to its impact on children.

Findings include:

• AIDS has become the leading cause of mortality among adults and one of the first in children
• the mortality associated with the disease has reduced life expectancy at birth from 65 years to 55 years in 2000
• since 1994 there has been an increase in child mortality
• more than others, HIV-affected children have no access to care when they are sick and drop out of school because they are orphans
• a considerable number of households with an AIDS-related death react with unsustainable strategies, selling their assets, reducing food expenditures, withdrawing children from school and living on external help
• no specific policy responses have been taken to address the social, economic, and legal consequences of HIV/AIDS.

The study recommends that the Government of Côte d'Ivoire should:

• create several health departments/districts in charge of the social management of HIV-affected families, notably AIDS-orphaned children
• extend the prevention of mother-to-child transmission of HIV (PMTCT) strategy to all health centers in the country in order to ensure specific therapeutic and psychosocial management of HIV-infected children and mothers
• ensure free education for HIV-affected children, in particular, and for all children, in general
• develop a formal assistance policy for needy patients in sanitary settings
• initiate more income-generating activities in favor of HIV-affected families
• set up referral clinics capable of ensuring biological diagnosis, and therapeutic and psychosocial management of HIV/AIDS in health districts
• allocate more resources to NGOs and community-based organisations effectively involved in the management of the consequences of HIV/AIDS
• establish a monitoring body for HIV/AIDS-risky sexual behavior
• better coordinate the actions for AIDS control
• scale up pilot actions, which have yielded satisfactory outcomes in view of improving them.

[adapted from author]