Following years of politicalinstability, Cote d’Ivoire has recorded a rapid growth rateover the past seven years and entrenched its status as alower-middle-income country. However, the country’sepidemiological profile remains comparable to that oflow-income countries, and health outcomes are among thepoorest in the region and globally. Furthermore, given itslower-middle-income status, domestic resource mobilizationand improving fiscal space are becoming increasinglyimportant considerations as several donors start to scaledown their assistance. To address this situation, thegovernment has committed to undertaking various reforms inthe health sector. The aim of this health financing systemassessment (HFSA) is to guide policy discussions throughassessment of the current context for implementation of thenational health sector reform agenda, transitioning fromdonor assistance and resource mobilization, and to identifyopportunities and options on the path toward universalhealth coverage (UHC). This HFSA discusses the macro-fiscalcontext in Cote d’Ivoire, reviews the health outcomes basedon most recently available data, analyzes the government andhealth financing landscape, and assesses the issues relatedto transitioning from external assistance for immunization.Based on the analysis, the HFSA concludes with specificpolicy recommendations for Cote d’Ivoire to reach universalhealth coverage.