ABIDJAN, Côte d’Ivoire — Côte d’Ivoire is expanding services to prevent and detect female genital schistosomiasis after a pilot in the country’s southwest found major gaps in women’s health care, including low awareness among health workers, limited access to preventive treatment and no routine services for many women at risk, March 2026. The scale-up reflects a broader push to move the neglected parasitic disease out of the margins of tropical medicine and into everyday sexual and reproductive health care.
The shift follows a pilot led with the Ministry of Health and partners in seven health centers in Soubré district, where researchers tested whether female genital schistosomiasis prevention could be folded into routine sexual and reproductive health services. Findings published in a peer-reviewed 2023 study showed the model was feasible and acceptable, while later program updates said the work exposed how easily at-risk women can be missed when national schistosomiasis programs focus mainly on school-age children.
Why female genital schistosomiasis is becoming a higher-priority women’s health issue
Female genital schistosomiasis, or FGS, is a manifestation of urogenital schistosomiasis caused by the parasite Schistosoma haematobium. According to the latest World Health Organization schistosomiasis fact sheet, women can develop genital lesions, vaginal bleeding, pain during sexual intercourse and vulvar nodules. Health specialists say those symptoms are often mistaken for sexually transmitted infections or other gynecological conditions, delaying diagnosis and deepening stigma.
That diagnostic blind spot was visible in Côte d’Ivoire’s pilot. Program summaries from partners said just 38% of health workers had heard of FGS before the study, and preventive treatment with praziquantel was not routinely available through health centers. A separate policy brief on the country’s experience said the evidence helped support a decision to expand services across two districts using both clinic-based and community outreach approaches.
Under the new expansion, Côte d’Ivoire and partners are working to identify women earlier, train more frontline staff, connect FGS prevention with sexual and reproductive health services, and integrate reporting into the national health information system, according to a recent scale-up overview from Unlimit Health.
How the Côte d’Ivoire pilot exposed critical service gaps
The pilot’s core lesson was simple: women of reproductive age were falling outside the usual treatment net. In many endemic areas, mass drug administration campaigns have historically targeted children, even though older adolescent girls and adult women continue to face repeated exposure through daily contact with infested water.
That matters because FGS sits at the intersection of infectious disease and reproductive health. The condition can contribute to chronic pain, bleeding, infertility and pregnancy-related complications, while also increasing vulnerability to other health problems. In January, the WHO’s Special Programme for Research and Training in Tropical Diseases said there remains a major equity gap because schistosomiasis control strategies still focus heavily on school-age children, leaving women’s reproductive health impacts under-addressed in many settings. The agency highlighted that concern in a recent update on closing equity gaps in schistosomiasis control.
In Côte d’Ivoire, that has pushed officials and advocates toward a more integrated model: instead of treating FGS as a niche tropical disease issue, they are placing it inside ordinary reproductive health consultations, HIV-related services and community awareness campaigns.
female genital schistosomiasis and the case for integrated care
Health advocates say the Côte d’Ivoire experience is important beyond one country because it offers a practical template for integration. Rather than waiting for women to seek specialist care they may never reach, the new approach brings prevention, counseling and treatment pathways closer to services they already use.
The case for that model has been building for years. In 2018, the WHO argued that screening and treating FGS alongside other reproductive health conditions could improve outcomes. In 2019, a joint WHO-UNAIDS brief warned that FGS had remained underreported, underdiagnosed and largely untreated, even as evidence linked it to wider sexual and reproductive health risks.
What looks different now is that countries such as Côte d’Ivoire are moving from advocacy to implementation. Recent workshops in the country have brought together actors from neglected tropical disease, HIV and maternal health programs to identify where FGS prevention can be embedded most effectively, according to a March 2026 program update.
What comes next in Côte d’Ivoire
The next test is whether the country can turn a successful pilot into durable routine care. That will depend on steady praziquantel access, better provider training, stronger referral pathways and enough public awareness to help women recognize symptoms early and seek care without stigma.
If the scale-up holds, Côte d’Ivoire could become one of the clearest examples yet of how to treat female genital schistosomiasis as both a neglected tropical disease and a women’s health issue. That distinction matters. For years, FGS has often been discussed as a hidden complication. The emerging approach in Côte d’Ivoire suggests it may be more useful to treat it as a visible systems failure — and one that health ministries can begin to fix.
