Médecine et Santé Tropicales


Analysis of the healthcare service decentralization process in Côte d’Ivoire Volume 24, issue 2, Avril-Mai-Juin 2014

1 Université de Montréal, École de psychoéducation, pavillon Marie-Victorin, local C. 428, 90 avenue Vincent-d’Indy, H2V 2S9 Montréal, Canada
2 Direction de la santé publique de Montréal, Montréal, Canada
3 École des éducateurs spécialisés, Institut national de formation sociale, Abidjan, Côte d’Ivoire
* Correspondance

The decentralization of healthcare services is becoming increasingly important in strategies of public sector management. This concept is analyzed from various points of view, including legal, economic, political, and sociological. Several typologies have been proposed in the literature to analyze this decentralization process, which can take different forms ranging from simple deconcentration to more elaborate devolution. In some instances, decentralization can be analyzed by the degree of autonomy given to local authorities. This article applies these typologies to analyze the healthcare system decentralization process in Cote d’Ivoire. Special attention is paid to the new forms of community healthcare organizations. These decentralized structures enjoy a kind of autonomy, with characteristics closer to those of devolution. The model might serve as an example for population involvement in defining and managing healthcare problems in Cote d’Ivoire. We end with proposals for the improvement of the process.