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Abstract: Following years of political instability, Côte d’Ivoire has recorded a rapid growth rate over the past seven years and entrenched its status as a lower-middle-income country. However, the country’s epidemiological profile remains comparable to that of low-income countries, and health outcomes are among the poorest in the region and globally. Furthermore, given its lower-middle-income status, domestic resource mobilization and improving fiscal space are becoming increasingly important considerations as several donors start to scale down their assistance. To address this situation, the government has committed to undertaking various reforms in the health sector. The aim of this Health Financing System Assessment (HFSA) is to guide policy discussions through assessment of the current context for implementation of the national health sector reform agenda, transitioning from donor assistance and resource mobilization, and to identify opportunities and options on the path toward universal health coverage (UHC). This HFSA discusses the macro-fiscal context in Côte d’Ivoire, reviews the health outcomes based on most recently available data, analyzes the government and health financing landscape, and assesses the issues related to transitioning from external assistance for immunization. Based on the analysis, the HFSA concludes with