Scaling up female genital schistosomiasis (FGS) prevention in Côte d'Ivoire

Female genital schistosomiasis (FGS) poses a risk to women in Côte d’Ivoire given that Schistosoma haematobium, the parasite responsible for this infection, remains high in some locations. 

Unlimit Health supported the Ministry of Health (MoH) Côte d’Ivoire to conduct a pilot study to further understand the problem and how to address it.  

The pilot study took place in seven health centres in the district of Soubré. The results indicated that:   

• There are no routine services available for FGS prevention or care 
• The treatment, praziquantel, is not routinely provided in health centres
• There is likely to be a high risk of transmission and exposure to infection with women using infected water sources for daily activities such as farming or social activities. 
•  Knowledge of FGS amongst health workers was low (an estimated 38% had heard of FGS prior to the pilot study) 
• Knowledge of FGS amongst women aged 15-29 years was negligible 
• 53% of women reported that they could not access treatment (praziquantel) on the same day if they needed it 

The MoH in Côte d’Ivoire is committed to: 

• Preventing FGS by identifying women at risk or at the early stages of disease progression and providing preventive treatment and health education
• Improving the use of resources by targeting services to the women identified as at risk 
• Integrating FGS prevention services with existing sexual and reproductive health services at the health centre level and as part of routine community outreach activities
• Integrating reporting with the existing health information system
• Raising awareness, by training health workers, and through health education for women at risk

Scaling up FGS prevention services

Using the results from the pilot study, Unlimit Health is working with the MoH to scale up FGS prevention services across two districts using a combined health centre and community outreach approach.

The health centre approach aims to improve the targeting of services through use of an FGS risk-assessment questionnaire and implementing a surveillance system. Reporting of at risk “cases” through the surveillance system will be used to target women in communities at risk with FGS prevention services.  

Integrating FGS services on a national scale

The ambition is for FGS prevention services to be provided routinely and sustainably on a national scale, alongside an integrated training programme. 

A working group of national experts including the MoH NTD Programme, the MoH HIV/AIDS Programme, the MoH Mother and Child Health Programme, the Governing Body of the National Health Information System and research institutions will provide technical and strategic guidance on the scale up approach. The results from the scale-up in two districts, and the pilot study, will be used to inform evidence-based guidelines for the national strategy for FGS.