Formal source
Actors and responsibilities
The plan assigns distinct private-sector stewardship, regional coordination and district action-planning roles.
MSHPCMU/DEPPS. Plan Stratégique National 2021-2025.
How the health system is organized
This profile follows the organizational chain from national institutions and subnational authorities to purchasers, provider organizations, referral networks, and people using services.
Reported source
Actors and responsibilities
The assessment describes primary, secondary and tertiary delivery levels while warning that norms and practice diverge.
World Bank Group. Health Systems Assessment for Côte d’Ivoire. 2020.
Reported source
Decision rights and autonomy
Historical conceptual autonomy and incomplete implementation evidence should not be collapsed into one present national autonomy score.
Soura and Coulibaly 2014; World Bank 2020.
Reported source
Decision rights and autonomy
Hospital directors have stated budget-execution roles, while PBF-facility evidence reports constrained HR authority.
Côte d’Ivoire hospital reform law 2019; Duran et al. 2020.
Reported source
Delivery and referrals
The system is described as tiered, while the assessment reports weak referral systems. This is not a national observed completion statistic.
World Bank Group. Health Systems Assessment for Côte d’Ivoire. 2020.
Observed source
Delivery and referrals
The assessment reports most outpatient visits at primary level and more bypassing in Abidjan. Savanes and Taabo studies provide subnational care-use evidence, not national bypass estimates.
World Bank 2020; Munos et al. 2018; Koné et al. 2022.
Observed source
Delivery and referrals
The mapping gives partial private-sector coverage, while a 2016 first-line malaria survey found higher operational capacity in surveyed public than private facilities. The law permits delegated public service without establishing universal contracting.
DEPPS/MSHPCMU 2023; Côte d’Ivoire hospital reform law 2019; Hounsa et al. 2019.
Formal source
Relationships and networks
The plan proposes revision of public-private referral and counter-referral guidance; it does not report adherence.
MSHPCMU/DEPPS. Plan Stratégique National 2021-2025.
Reported source
Relationships and networks
First-contact facilities detect and refer suspected leprosy cases to intermediate level within the programme described.
Yotsu et al. 2020.
Formal source
Reform and institutional change
The evidence distinguishes hospital law, private-sector planning and a later phase-one facility mapping, without inferring reform effects.
Côte d’Ivoire 2019 law; MSHPCMU/DEPPS plan 2021-2025; DEPPS mapping 2023.
Open the interactive organization graph and national-subnational decision matrix
Methods, evidence, and data
Source traceability, coverage, citations, locators, source versions, and annotation materials are grouped here so the organizational synthesis remains the primary reading flow.
Directly mapped computable objects
Source-linked mappings drive the visible country synthesis and remain open for annotation. Canonical registries are reported separately so a zero in that publication layer is never mistaken for absent evidence.
| Object | Count | Meaning |
|---|---|---|
| Source-linked analytical mappings | 10 | Cited mappings rendered across the organization, decision, delivery, network, autonomy, and reform views. |
| Source-linked analytical object rows | 29 | Named graph nodes and edges, function assignments, decision cells, autonomy cells, pathways, and reform events supplied by those mappings. |
| Actors | 0 | Actors with explicit identity, territory, time, and evidence lineage. |
| Relationships | 0 | Evidence-backed actor-to-actor or actor-to-provider edges. |
| Decision rights | 0 | Actor, function, decision, and role assignments. |
| Provider organizations | 0 | Named or typed providers with evidence-backed ownership and management. |
| Autonomy records | 0 | Decision-domain authority paired with an autonomous-from actor. |
| Accountability records | 0 | Accountable-to actor and mechanism. |
| Referral designs | 0 | Formal referral, choice, bypass, and counter-referral arrangements. |
| Observed flows | 0 | Observed referral, bypass, mobility, or network flows. |
Source traceability and coverage
These six documentation measures describe the traceability available for displayed materials: domain coverage, public URLs, exact locators, source versions, and typed mappings. They do not measure health-system performance, source truth, institutional quality, or country success. A zero never means that an actor, authority, relationship, service, or activity is absent.
Documentation status: Explicit analytical mappings. All six source-traceability measures meet or exceed 80%. Materials remain open for annotation and country-specific refinement.
- Domain leads
- 100%17 of 17
- Source layers
- 100%3 of 3
- Public URLs
- 100%24 of 24
- Exact locators
- 88%21 of 24
- Source versions
- 100%24 of 24
- Typed mapping
- 100%5 of 5
Traceability gaps to address
- Review and annotate the country synthesis
All six preparation dimensions meet the target. Every source-linked finding and supporting material remains open for correction, qualification, and additional evidence through annotations.
Coverage by organizational domain
Source traceability across all 17 organizational domains
| Domain | State | Materials | URLs | Locators | Versions | Statements | Contexts | Typed |
|---|---|---|---|---|---|---|---|---|
| ActorsCritical | Direct typed mapping | 11 | 11 | 8 | 11 | 7 | 7 | 3 |
| Government responsibilitiesCritical | Direct typed mapping | 8 | 8 | 5 | 8 | 4 | 4 | 1 |
| Provider ownershipCritical | Direct typed mapping | 7 | 7 | 7 | 7 | 7 | 7 | 2 |
| Decision rightsCritical | Direct typed mapping | 9 | 9 | 9 | 9 | 9 | 9 | 4 |
| Provider autonomyCritical | Direct typed mapping | 6 | 6 | 6 | 6 | 6 | 6 | 2 |
| Primary care organizationCritical | Direct typed mapping | 18 | 18 | 15 | 18 | 14 | 14 | 6 |
| Hospital organizationCritical | Direct typed mapping | 8 | 8 | 8 | 8 | 8 | 8 | 4 |
| Referral designCritical | Direct typed mapping | 7 | 7 | 7 | 7 | 7 | 7 | 4 |
| Observed referral | Direct typed mapping | 8 | 8 | 8 | 8 | 8 | 8 | 3 |
| Provider networks | Direct typed mapping | 5 | 5 | 5 | 5 | 5 | 5 | 2 |
| Facility data | Direct typed mapping | 8 | 8 | 8 | 8 | 8 | 8 | 3 |
| Utilization | Direct typed mapping | 5 | 5 | 5 | 5 | 5 | 5 | 1 |
| Patient flows | Direct typed mapping | 8 | 8 | 8 | 8 | 8 | 8 | 3 |
| Governance and accountabilityCritical | Direct typed mapping | 16 | 16 | 13 | 16 | 12 | 12 | 7 |
| Market structure | Direct typed mapping | 9 | 9 | 9 | 9 | 9 | 9 | 4 |
| Reform historyCritical | Direct typed mapping | 8 | 8 | 8 | 8 | 7 | 7 | 3 |
| Authoritative review | Direct typed mapping | 20 | 20 | 20 | 20 | 20 | 20 | 10 |
Materials with the most complete source traceability
- Health Systems Assessment for Côte d’Ivoire: Accelerating Reforms Toward Universal Health Coverage
Country Improvement Source Lead. Readiness checks: 5 of 5.
material:de1b505b6a5565cc98d3b0bf - Impact of newly constructed primary healthcare centres on antenatal care attendance, facility delivery and all-cause mortality: quasi-experimental evidence from Taabo health and demographic surveillance system, Côte d’Ivoire
Country Improvement Source Lead. Readiness checks: 5 of 5.
material:dbcf002f5306d193d5739268 - Private-facility mapping, first-line capacity and delegated service
Candidate Analytical Mapping. Readiness checks: 5 of 5.
material:db591f62dd0c917e8525ae1c - Loi n°2019-678 du 23 juillet 2019 portant réforme hospitalière
Country Improvement Source Lead. Readiness checks: 5 of 5.
material:d5f20e7277ab3c126a3605c4 - Evaluation de la capacité opérationnelle des établissements sanitaires de première ligne dans la prise en charge du paludisme en Côte d’Ivoire
Country Improvement Source Lead. Readiness checks: 5 of 5.
material:c5003d1f0c4e9f07a0e7b736
Complete country materials
Every collected library candidate, queue record, source lead, statement, context, machine flag, and public projection assigned to this country is rendered below. Each item remains open for text-anchored annotation. A missing direct analytical mapping never hides the broader material.
- All material records
- 24
- Library documents
- 0
- Queue records
- 23
- Public-stage records
- 1
- Cited source records
- 1
- Source-linked statements
- 0
- Exact contexts
- 0
- Structured source-linked findings
- 10
- Direct typed relationships
- 0
All collected materials
24 records are rendered in full. Stage duplicates remain visible because a document candidate, triage record, statement, and exact context are separately annotatable objects.
Candidate Analytical Mapping · Open for annotation
Budget execution and HR authority are distinct
Côte d’Ivoire hospital reform law 2019; Duran et al. 2020.
Statement or annotation question
Hospital directors have stated budget-execution roles, while PBF-facility evidence reports constrained HR authority.
Source context or anchor
health facilities cannot hire or fire health workers
Annotation prompts and machine flags
- Never translate these bounded findings into a national autonomy score.
Source links
Candidate Analytical Mapping · Open for annotation
Decentralization is not a uniform autonomy finding
Soura and Coulibaly 2014; World Bank 2020.
Statement or annotation question
Historical conceptual autonomy and incomplete implementation evidence should not be collapsed into one present national autonomy score.
Source context or anchor
decentralized structures enjoy a kind of autonomy
Annotation prompts and machine flags
- Keep historical and implementation layers separate.
Source links
Candidate Analytical Mapping · Open for annotation
Hospital and private-sector reform sequence
Côte d’Ivoire 2019 law; MSHPCMU/DEPPS plan 2021-2025; DEPPS mapping 2023.
Statement or annotation question
The evidence distinguishes hospital law, private-sector planning and a later phase-one facility mapping, without inferring reform effects.
Source context or anchor
La DEPPS a la charge du secteur privé
Annotation prompts and machine flags
- Legal and planning milestones do not establish observed results.
Source links
Candidate Analytical Mapping · Open for annotation
Leprosy referral pathway is programme-specific
Yotsu et al. 2020.
Statement or annotation question
First-contact facilities detect and refer suspected leprosy cases to intermediate level within the programme described.
Source context or anchor
detecting and referring all suspicious cases
Annotation prompts and machine flags
- Do not generalize to all conditions.
Source links
Candidate Analytical Mapping · Open for annotation
National, regional and district private-sector roles
MSHPCMU/DEPPS. Plan Stratégique National 2021-2025.
Statement or annotation question
The plan assigns distinct private-sector stewardship, regional coordination and district action-planning roles.
Source context or anchor
La DEPPS a la charge du secteur privé
Annotation prompts and machine flags
- Stated roles are not implementation results.
Source links
Candidate Analytical Mapping · Open for annotation
Primary-care use with bounded subnational evidence
World Bank 2020; Munos et al. 2018; Koné et al. 2022.
Statement or annotation question
The assessment reports most outpatient visits at primary level and more bypassing in Abidjan. Savanes and Taabo studies provide subnational care-use evidence, not national bypass estimates.
Source context or anchor
where bypassing is more common
Annotation prompts and machine flags
- Do not convert regional linking or Taabo results into national referral completion.
Source links
Candidate Analytical Mapping · Open for annotation
Private-facility mapping, first-line capacity and delegated service
DEPPS/MSHPCMU 2023; Côte d’Ivoire hospital reform law 2019; Hounsa et al. 2019.
Statement or annotation question
The mapping gives partial private-sector coverage, while a 2016 first-line malaria survey found higher operational capacity in surveyed public than private facilities. The law permits delegated public service without establishing universal contracting.
Source context or anchor
3187 établissements sanitaires privés ont été cartographiés
Annotation prompts and machine flags
- Keep the malaria-management and first-line survey scope visible; do not use facility counts as delivery-dominance conclusions.
Source links
Candidate Analytical Mapping · Open for annotation
Public-private referral guidance is a planned reform
MSHPCMU/DEPPS. Plan Stratégique National 2021-2025.
Statement or annotation question
The plan proposes revision of public-private referral and counter-referral guidance; it does not report adherence.
Source context or anchor
Réviser les directives de référence et de contre référence
Annotation prompts and machine flags
- Do not call the guidance implemented.
Source links
Candidate Analytical Mapping · Open for annotation
Reported three-tier delivery architecture
World Bank Group. Health Systems Assessment for Côte d’Ivoire. 2020.
Statement or annotation question
The assessment describes primary, secondary and tertiary delivery levels while warning that norms and practice diverge.
Source context or anchor
Côte d’Ivoire has a three-tiered health service delivery system
Annotation prompts and machine flags
- Do not infer uniform capacity across levels.
Source links
Candidate Analytical Mapping · Open for annotation
Tiered architecture and reported referral weakness
World Bank Group. Health Systems Assessment for Côte d’Ivoire. 2020.
Statement or annotation question
The system is described as tiered, while the assessment reports weak referral systems. This is not a national observed completion statistic.
Source context or anchor
weak referral systems pose a barrier
Annotation prompts and machine flags
- Keep formal design distinct from reported implementation.
Source links
Country Improvement Source Lead · Open for annotation
Cartographie des établissements sanitaires privés en Côte d’Ivoire
DEPPS/MSHPCMU. Cartographie des établissements sanitaires privés en Côte d’Ivoire. 2023. https://www.depps.sante.gouv.ci/DocPDF/DOCUMENTS%20DE%20R%C3%89F%C3%89RENCE/RAPPORT%20CARTOGRAPHIE%20ESPr%20IQVIA%20-%20BM_DEPPS.pdf
Statement or annotation question
The phase-one mapping recorded 3,187 private facilities and describes incomplete national coverage; it reports inpatient availability for surveyed facilities.
Source context or anchor
3187 établissements sanitaires privés ont été cartographiés
Annotation prompts and machine flags
- Do not call the phase-one count the complete private-sector census.
Source links
Country Improvement Source Lead · Open for annotation
Décentralisation et santé communautaire en Côte d’Ivoire
Soura AB, Coulibaly A. Décentralisation et santé communautaire en Côte d’Ivoire. Med Santé Trop. 2014;24(2):151-156. https://pubmed.ncbi.nlm.nih.gov/24334434/
Statement or annotation question
The review characterizes decentralized community-health structures as having autonomy closer to devolution; it is not a current national autonomy inventory.
Source context or anchor
decentralized structures enjoy a kind of autonomy
Annotation prompts and machine flags
- Do not convert the conceptual review into a present nationwide score.
Source links
Country Improvement Source Lead · Open for annotation
Evaluation de la capacité opérationnelle des établissements sanitaires de première ligne dans la prise en charge du paludisme en Côte d’Ivoire
Hounsa AE, et al. Pan African Medical Journal. 2019;34:16. https://www.ebi.ac.uk/europepmc/webservices/rest/PMC6859026/fullTextXML
Statement or annotation question
Among 818 surveyed first-line facilities, malaria-management operational capacity was higher in public than private facilities.
Source context or anchor
higher in the public sector than in the private sector
Annotation prompts and machine flags
- Keep malaria-management, first-line and 2016 survey scope visible.
Source links
Country Improvement Source Lead · Open for annotation
Health Systems Assessment for Côte d’Ivoire: Accelerating Reforms Toward Universal Health Coverage
World Bank Group. Health Systems Assessment for Côte d’Ivoire. 2020. https://documents1.worldbank.org/curated/en/186071589777801915/pdf/Health-Systems-Assessment-for-Cote-d-Ivoire-Accelerating-Reforms-Toward-Universal-Health-Coverage.pdf
Statement or annotation question
The assessment describes a three-tier delivery system, reports weak referral systems as an access barrier and distinguishes formal norms from practice.
Source context or anchor
weak referral systems pose a barrier
Annotation prompts and machine flags
- Do not present weak referral reporting as a national completion rate.
Source links
Country Improvement Source Lead · Open for annotation
Impact of newly constructed primary healthcare centres on antenatal care attendance, facility delivery and all-cause mortality: quasi-experimental evidence from Taabo health and demographic surveillance system, Côte d’Ivoire
Koné S, et al. BMJ Open. 2022;12:e054355. https://www.ebi.ac.uk/europepmc/webservices/rest/PMC8808407/fullTextXML
Statement or annotation question
In four targeted Taabo villages, opening primary healthcare facilities reduced mean distance to care without observed improvement in antenatal attendance or institutional deliveries.
Source context or anchor
No improvement was observed for ANC attendance, institutional deliveries and adult mortality.
Annotation prompts and machine flags
- Keep Taabo and four-facility scope visible; do not generalize nationally.
Source links
Country Improvement Source Lead · Open for annotation
Integrated management of Buruli ulcer and leprosy in Côte d’Ivoire
Yotsu RR, et al. Integrated management of Buruli ulcer and leprosy in Côte d’Ivoire. 2020. https://europepmc.org/articles/PMC7164353
Statement or annotation question
For leprosy, first-contact facilities detect and refer suspected cases to intermediate level; this is programme-specific.
Source context or anchor
detecting and referring all suspicious cases
Annotation prompts and machine flags
- Do not generalize programme referral to all conditions.
Source links
Country Improvement Source Lead · Open for annotation
Loi n°2019-678 du 23 juillet 2019 portant réforme hospitalière
République de Côte d’Ivoire. Loi n°2019-678 du 23 juillet 2019 portant réforme hospitalière. 2019. https://www.depps.sante.gouv.ci/DocPDF/DOCUMENTS%20DE%20R%C3%89F%C3%89RENCE/LOI%20N%C2%B02019-678%20DU%2023%20JUILLET%202019%20PORTANT%20REFORME%20HOSPITALIERE.pdf
Statement or annotation question
The law assigns public-hospital budget execution to directors, oversight of annual budget proposals to hospital councils, and permits delegated public hospital service through convention.
Source context or anchor
Le Directeur est l’ordonnateur de l’EPH
Annotation prompts and machine flags
- Budget execution is not full fiscal autonomy.
Source links
Country Improvement Source Lead · Open for annotation
Measuring effective coverage of maternal and child health interventions in Côte d’Ivoire
Munos MK, et al. Journal of Global Health. 2018. https://europepmc.org/articles/PMC6211616?pdf=render
Statement or annotation question
The study documents mixed public, NGO, religious and private care sources in Savanes and bounded care-seeking episodes.
Source context or anchor
dominated by public first-level health centers
Annotation prompts and machine flags
- Do not infer national referral rates from Savanes.
Source links
Country Improvement Source Lead · Open for annotation
Performance-based financing and health-system governance in Côte d’Ivoire
Duran D, et al. Performance-based financing and health-system governance in Côte d’Ivoire. BMJ Global Health. 2020. https://europepmc.org/articles/PMC7528372
Statement or annotation question
In PBF facilities, committees allocate PBF funds, while facilities lack authority to hire or fire staff.
Source context or anchor
health facilities cannot hire or fire health workers
Annotation prompts and machine flags
- Keep PBF-facility scope and qualitative design visible.
Source links
Country Improvement Source Lead · Open for annotation
Plan Stratégique National d’Intégration et de Développement du Secteur Privé de la Santé 2021-2025
MSHPCMU/DEPPS. Plan Stratégique National d’Intégration et de Développement du Secteur Privé de la Santé 2021-2025. https://www.depps.sante.gouv.ci/DocPDF/DOCUMENTS%20DE%20R%C3%89F%C3%89RENCE/PLAN%20STRATEGIQUE%20NATIONAL%20IDSPS.pdf
Statement or annotation question
The plan assigns DEPPS private-sector responsibility, regional coordination and district action planning, and identifies public-private referral-guidance revision as planned reform.
Source context or anchor
La DEPPS a la charge du secteur privé
Annotation prompts and machine flags
- Planned referral revision is not observed implementation.
Source links
Displayed source projection · Open for annotation
Stratégie de coopération OMS 2016-2020: Cote d'Ivoire
WHO Regional Office for Africa. Stratégie de coopération OMS 2016-2020: Cote d'Ivoire. 2016. https://www.who.int/fr/publications-detail/9789290312659
Annotation prompts and machine flags
- Public source projection retained as a distinct stage record.
Source links
Official Locator Gap Source Lead · Open for annotation
Stratégie de coopération de l'OMS avec la Côte d'Ivoire 2022-2025
World Health Organization Regional Office for Africa. Stratégie de coopération de l'OMS avec la Côte d'Ivoire 2022-2025. World Health Organization Regional Office for Africa. 2023. https://www.afro.who.int/node/19147
Annotation prompts and machine flags
- Official WHO source identified during the country locator-gap audit.
- Immutable source-version metadata was retrieved from this exact public source URL in the locator-gap traceability audit.
- A recoverable source locator was retrieved from this exact public source URL in the locator-gap traceability audit.
Source links
Source Triage Record · Open for annotation
Stratégie de coopération OMS 2016-2020: Cote d'Ivoire
WHO Regional Office for Africa. Stratégie de coopération OMS 2016-2020: Cote d'Ivoire. 2016. https://www.who.int/fr/publications-detail/9789290312659
Annotation prompts and machine flags
- Verify the exact bibliographic citation against the original source.
- Confirm that the document applies to the named country and intended territorial scope.
- Confirm document type, issuing institution, authority, and claim-specific suitability.
- Retrieve and hash the exact source version when it is not already verified.
- Check publication date, effective period, currency, and supersession risk.
- Confirm only domains directly supported by the reviewed source.
- Add substantive feedback directly through the text-anchored annotation layer.
Source links
Targeted Source Lead · Open for annotation
Stratégie de coopération OMS 2016-2020: Cote d'Ivoire
WHO Regional Office for Africa. Stratégie de coopération OMS 2016-2020: Cote d'Ivoire. 2016. https://www.who.int/fr/publications-detail/9789290312659
Annotation prompts and machine flags
- Authoritative official source page or publication exposes country-specific health-system organization, governance, delivery, or primary-care context.
- Immutable source-version metadata is linked from another displayed stage record with the exact same source URL.