CHEER – Cocoa Health and Empowerment for Economic Resilience
A pilot project improving the health and economic resilience of cocoa producing households in Côte d’Ivoire.
The project at glance
Project Goals
The project strengthens the resilience of cocoa-farming households by improving access to health insurance, enhancing health services and promoting preventive care. Cocoa farming is physically demanding, household income depends heavily on farmers’ health, and illness can severely disrupt livelihoods and farm productivity. Limited healthcare infrastructure and low awareness of health insurance leave many families vulnerable to high medical costs. By facilitating access to the national Universal Health Coverage (CMU), the project helps ensure farmers can receive care when needed. Complementary support fills gaps in coverage, providing financial protection for essential and emergency services. Together, these efforts help cocoa-farming households maintain health, secure income, and build long-term resilience.
With our partners we aim to strengthen the health and economic resilience of producers in the cocoa supply chain of Tony’s Open Chain.
The key objectives are:
Improve access to healthcare through affordable and high-quality medical services.
Strengthen the financial resilience of households by minimising the burden of healthcare costs and productivity losses.
Support the national health system by promoting CMU registration and quality improvements in health centres.
Improve data collection and reporting to better manage social risks and human rights issues.
Project Implementation
Improving health insurance access and healthcare quality will boost cocoa producing households’ incomes by reducing medical expense burdens and improving health, which can enhance their productivity.
The main project activities are:
- Raise the quality of health services by identifying areas for improvement in health facilities; developing quality improvement plans with local health workers and providing support in staff training, equipment, and infrastructure upgrades to raise healthcare standards.
- Support preventive, community-based health services by deploying mobile clinics staffed by local healthcare professionals to bring preventive care directly into communities, for example through vaccination campaigns.
- Promote Enrolment and Awareness of the CMU by creating awareness and guiding through registration to ensure effective use of services under the national scheme. Elucid strengthens the CMU’s impact by covering gaps: while CMU finances a core package of care, we provide complementary financial assistance for essential and emergency services at farmer facilities, preventing out-of-pocket costs from becoming a barrier.
- Ease access to healthcare services – Farmers receive care from partner providers, with claims submitted through the Elucid platform to streamline reimbursement and ensure transparency.
Project partners
Tony’s Chocolonely manages ethical chocolate production by working closely with West African cocoa farmers across the entire supply chain. Its Tony’s Open Chain initiative promotes a fairer, more transparent chocolate industry and invites other companies to adopt its sustainable sourcing practices. This initiative offers opportunities to attract new partners, expand the pilot to more cooperatives and communities, and scale project activities. Through the Chocolonely Foundation it supports projects and organisations, like this initiative, that contribute to decent livelihoods in cocoa growing communities in Côte d’Ivoire and Ghana, facilitate systemic change, and challenge the status quo.
Elucid Health is a German non-profit organization with a local branch in Côte d’Ivoire. Its focus is on access to healthcare.
The project works in close synergy with a broader Gavi initiative. While the CHEER project focuses on improving health care access for cocoa-producing communities, the GAVI initiative complements these efforts with targeted immunisation campaigns (particularly against malaria and HPV) and the strengthening of health infrastructure in the same and further regions. An accompanying scientific evaluation by Charité – Universitätsmedizin Berlin and the Transformation for Development Institute at Université Alassane Ouattara systematically examines the effectiveness and sustainability of these combined approaches. The efforts are implemented in close collaboration with the Ministry of Health, La Couverture Maladie Universelle (CMU), the Caisse Nationale d'Assurance Maladie (CNAM), the Conseil du Café-Cacao (CCC), and Gavi, the Vaccine Alliance.
Outlook
Access to healthcare is a fundamental human right and an essential part of achieving a living income for smallholder cocoa farmers in Côte d’Ivoire. While many initiatives focus on improving productivity, market access, women’s empowerment, and environmental sustainability, basic health care remains out of reach for many farming families. When illness strikes, farmers not only face high medical costs but also lose valuable labor and income, often pushing them back into poverty and limiting their ability to invest in their farms. This lack of healthcare access undermines progress toward fair, sustainable, and inclusive supply chains. Addressing health is therefore a critical next step in our work to strengthen the resilience of smallholder households and ensure that human rights are respected throughout the cocoa sector.