Interview: Eric Djibo
What are the major deficiencies in Côte d’Ivoire’s health care system and provision?
ERIC DJIBO: Cardiology and cancer treatment are major gaps in our health care sector. For the former, we currently lack cutting-edge equipment, such as interventional radiology, for the treatment of certain diseases. Given that a single public establishment – the cardiology Institute of Abidjan – is equipped, a number of private facilities have begun investing in the segment. For cancer treatment we are in the same situation; PISAM will soon open its radio therapy ward – with two, last-generation accelerators – and the University Hospital Centre of Cocody is said to be opening its own. Partnerships will also need to be created between local and foreign institutions, to either train or operate these new centres once they are in operation.
Indeed, the government could do more to ensure that health care facilities have access to the necessary equipment by relaxing cost constraints. For instance, the state could exempt the purchase of last-generation medical equipment from taxes and Customs duties to allow us to pursue our investments in advanced technologies. The Investment Promotion Agency of Côte d’Ivoire provides advantages when companies invest over a certain threshold, but for those seeking to spread their investment over several years, Customs taxes remain prohibitive. Another challenge facing the sector has been the lack of local laboratories and diagnostics infrastructure. Even today a number of samples are sent directly to France for testing, resulting in long delays. Indeed, investments are being made at the national level, but more is needed.
What role can digitalisation play in improving doctor-patient relationships?
DJIBO: As demand increases, health care facilities must look to improve processes and become more efficient, without affecting the quality of service. In this context digitalisation and automation offer the best alternative. An integrated hospital information system is essential to allow health care centres to organise themselves based on the needs of the patients. Not only will it provide much needed transparency for clients on medical fees, but it will allow them to access their medical history and exam results via an online platform. For their part, health care professionals and administrators will be able to remotely monitor the management of patients, and more importantly, ensure better patient follow-up through the use of various alerts, such as treatment schedules. To this, we can add management parameters such as room occupation rates, capacity availability and demand, and optimise the number of visits per doctor on a given day – a process that in the past traditionally resulted in longer consultation times or professional faults. These single client dossiers can then be utilised by all health care stakeholders, from public health care institutions and the Ministry of Health, to the National Health Insurance Fund or private insurance companies. With regard to online consultation, however, I believe that it offers great potential to those unable to physically access health care, such as those in rural areas.
How can instances of repatriation be lowered?
DJIBO: Traditionally, Côte d’Ivoire was celebrated for having some of the best health care facilities and professionals in the region. However, a chronic lack of investment during the last decade has threatened this reputation. Most repatriations are mainly for treatment of cardiovascular diseases or cancer treatments through radiotherapy. However, thanks to recent efforts from the private and public sector we should soon be able to cater to the local, and even regional, market. By the end of 2018 Côte d’Ivoire will have at least three interventional radiology machines and more than six nuclear accelerators. These are noticeable advances that epitomise the country’s great ambition to reach emerging country status by the year 2020.
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