Terminal Illness & End-of-Life Planning in Côte d'Ivoire: 5-Step Official Checklist

1. 1

   Coordinating palliative care, hospital pathways, and Universal Health Coverage

   • Tiered healthcare pathway and referral hospitals: In Côte d'Ivoire, care for serious or progressive illnesses follows the national healthcare pyramid from primary health centres to Regional Hospital Centres (CHR), University Hospital Centres (CHU of Cocody, Treichville, Angré, Yopougon, or Bouaké), and specialist institutes such as the Alassane Ouattara National Centre for Medical Oncology and Radiotherapy (CNRAO) [1] [2]. The supervising medical team coordinates specialist treatment, pain management, and inpatient or outpatient palliative care [1] [2].
   • Universal Health Coverage (CMU) benefits: Administered by the National Health Insurance Fund (CNAM), the CMU covers 70% of the cost of consultations, laboratory tests, hospitalisations, and medications on the official list at accredited public health facilities and pharmacies, with a 30% co-payment paid by the insured person [1]. Practical rules are set out on the Portail Officiel des Services Publics de Côte d'Ivoire [1].
   • Supplementary health insurance and mutual funds: For state employees affiliated with the General Mutual Fund for Civil Servants and State Employees of Côte d'Ivoire (MUGEF-CI) or private-sector workers covered by private health insurance, prior authorisation should be requested for major procedures and supportive care at home [1] [2].
2. 2

   Recording advance medical wishes and designating a trusted representative

   • Written statement of care preferences: While your relative retains full mental capacity, it is advisable to prepare a dated and signed written document stating their wishes regarding treatment goals, palliative support, pain management, and any refusal of disproportionate interventions [1] [2]. This written statement is provided to the attending physician for inclusion in the hospital medical record [2].
   • Designating a family medical spokesperson: Under medical ethics rules applicable in Côte d'Ivoire, the patient's free and informed consent governs every medical intervention, and physicians consult designated relatives when the patient can no longer express their wishes [1] [2]. Formally designating a trusted person in writing establishes a clear family spokesperson for the healthcare team [2] [5].
   • Centralising medical records: The patient may expressly authorise this representative to obtain medical reports, hospital discharge summaries, and certificates needed for the Health Board (conseil de santé) or social security funds [2] [3].
3. 3

   Bank powers of attorney, notarial mandates, and legal protection

   • Bank account powers of attorney: While the ill person retains full legal capacity, they may execute a bank power of attorney at their bank branches in Côte d'Ivoire in favour of a trusted representative [5]. This mandate allows the representative to pay hospital bills, cover household expenses, and collect salaries or pensions without interruption [3] [5].
   • Authentic power of attorney before a notary: For broader property and financial administration (managing real estate, collecting rent, or dealing with tax and land authorities), your relative should sign a general or special power of attorney by authentic deed before an Ivorian notary, who can travel to the home or clinic to record the grantor's consent [5].
   • Judicial protection measures in case of incapacity: If the progression of the illness later causes a medically certified impairment of mental or physical faculties preventing the expression of intent, the family may petition the guardianship judge at the competent Court of First Instance (Tribunal de première instance) to open a statutory adult protection measure (guardianship or curatorship) [5].
4. 4

   Long-term sick leave, disability pensions, and caregiver support

   • Health Board assessment and long-term sick leave: For civil servants and public employees affected by a severe and disabling condition requiring extended absence, an application for an assessment before the Health Board (conseil de santé, notably at the CHU of Cocody) must be submitted based on a detailed medical report in order to obtain long-term sick leave with statutory salary continuation [2].
   • Private-sector disability pension (CNPS): If your relative is a private-sector employee who suffers a permanent reduction of at least two-thirds of their working or earning capacity certified by the social security medical adviser, a claim for a disability pension (or early retirement for medical incapacity) may be filed with the Caisse Nationale de Prévoyance Sociale [3]. The file includes the medical certificate of incapacity, salary statements, civil status extract, and certificate of cessation of employment [3].
   • Public-sector disability pension (CGRAE) and caregiver leave: Where a civil servant is declared permanently unfit for service by the Health Board, disability or early retirement pension entitlements are processed through the Caisse Générale de Retraite des Agents de l'État [2] [4]. Employed family caregivers may request exceptional paid or unpaid leave permissions or working-hour adjustments under the Ivorian Labour Code and the interprofessional collective agreement [3].
5. 5

   Will preparation, life insurance beneficiaries, and estate planning

   • Statutory forms of wills in Côte d'Ivoire: Under Ivorian law governing gifts and successions, any person of sound mind may arrange the transfer of their estate through a holographic will (written, dated, and signed entirely in the testator's own handwriting), a public authentic will executed before a notary, or a mystic (sealed) will [5]. Executing a notarised authentic will avoids any risk of loss or challenge regarding formal validity [5].
   • Respecting statutory forced heirship rules: When drafting a will, your relative must comply with the statutory forced share (réserve héréditaire, which amounts to three-quarters of the estate when the testator leaves children or descendants, or one-half where there is a surviving spouse or ascendants without descendants), as only the disposable portion may be freely bequeathed [5].
   • Reviewing life insurance policies and civil status records: It is essential to verify beneficiary clauses on life insurance and provident policies and compile in a secure folder the original National Identity Card (CNI), birth and marriage extracts, land title certificates (ACD or certificats de propriété foncière), and bank statements [1] [3] [5]. Where an asset or heir is located abroad, the notary coordinates cross-border legal recognition [5].

Official Authorities & Verified Contacts

Official Sources Checked by Clarvia

1. [1]
   Universal Health Coverage (CMU - CNAM) Benefits and Care Package — Portail Officiel des Services Publics de Côte d'Ivoire
2. [2]
   Health Board Consultation for Long-Term Sick Leave (Conseil de santé) — Portail Officiel des Services Publics de Côte d'Ivoire
3. [3]
   Required Documents for Pension and Disability Benefit Claims — Caisse Nationale de Prévoyance Sociale (IPS-CNPS)
4. [4]
   Disability and Retirement Pension Scheme for State Employees — Caisse Générale de Retraite des Agents de l'État (IPS-CGRAE)
5. [5]
   Judicial Services and Official Court Acts in Côte d'Ivoire — Portail Officiel du Gouvernement de Côte d'Ivoire