Obstetric emergencies in a humanitarian context at the Somine Dolo hospital in Mopti, Mali

Background: Conflicts are a barrier to physical and financial access to health centers. Our objective was to evaluate obstetric emergencies in a humanitarian context at the Sominé DOLO hospital in Mopti.Methods: This was a descriptive and prospective longitudinal study from January to September, 2020 in the obstetrical gynecology department of the Sominé DOLO hospital in Mopti. Our objective was to evaluate obstetric emergencies in the humanitarian context.Results: The frequency of patients evacuated was 30.61%. The average age of the patients was 27 years with extremes of 15 and 49 years. Hemorrhage during pregnancy was the main cause of reference with 23.83%. The ambulance was the most used means of transport with 51%. Delay in evacuation was observed in 31.33 cases. About 73.03% of our patients had given birth by caesarean section. We recorded 64 maternal deaths, a rate of 10.67%. Fetal mortality in our study was 23.28%. Attacks by armed groups had a negative impact on the referral/evacuation system.Conclusions: The health system had experienced severe challenges due to insecurity. Armed conflicts were the cause of evacuation delays. Haemorrhage during pregnancy was the main reference cause. Maternal and perinatal mortality was high

Conclusions of ten years of maternal death surveillance and response in the health district of commune V of Bamako, Mali

Background: The purpose of this study was to report the findings of the local maternal deaths surveillance and response (MDSR) committee in the health district of Municipality V of the district of Bamako. Methods: It was a retrospective study over a period from January 2009 to December 2017. We have compiled all the findings of the local MDSR committee from the health district of Municipality V. The data was generated from the Local Health Information System (LHIS). We made a simple entry of text and tables using Word and Excel software. Results: During the study period, the maternal mortality ratio (MMR) was 219/100,000 live births. The study was about 140 cases of maternal deaths that occurred in health facilities. The middle age of the patients was 28.01 years. Most of the deaths occurred in the postpartum period, with 106 cases. In 92.12%, the deaths were from direct obstetric causes (DOC), including hemorrhage 70%, eclampsia 7.85%, obstructed labor 7.14%. Seven deaths (5%) were from indirect obstetric causes (IOC), including anemia 3.57% and malaria 1.73%. In 2.58%, the deaths were from undetermined causes. Deaths were preventable in 80%. The response included, among other things, the notification of cases and the implementation of the recommendations made. In 70% of cases, the recommendations issued were implemented. Conclusions:  The MMR remains high in Municipality V of the district of Bamako. These deaths were mostly from DOCs, with hemorrhage as the main cause. These deaths were mostly preventable.

The Costs of Implementing Vaccination With the RTS,S Malaria Vaccine in Five Sub-Saharan African Countries.

Background. The World Health Organization has recommended pilot implementation of a candidate vaccine against malaria (RTS,S/AS01) in selected sub-Saharan African countries. This exploratory study aimed to estimate the costs of implementing RTS,S in Burkina Faso, Ghana, Kenya, Mozambique, and Tanzania. Methods. Key informants of the expanded program on immunization at all levels in each country were interviewed on the resources required for implementing RTS,S for routine vaccination. Unit prices were derived from the same sources or from international price lists. Incremental costs in 2015 US dollars were aggregated per fully vaccinated child (FVC). It was assumed the four vaccine doses were either all delivered at health facilities or the fourth dose was delivered in an outreach setting. Results. The costs per FVC ranged from US$25 (Burkina Faso) to US$37 (Kenya) assuming a vaccine price of US$5 per dose. Across countries, recurrent costs represented the largest share dominated by vaccines (including wastage) and supply costs. Non-recurrent costs varied substantially across countries, mainly because of differences in needs for hiring personnel, in wages, in cold-room space, and equipment. Recent vaccine introductions in the countries may have had an impact on resource availability for a new vaccine implementation. Delivering the fourth dose in outreach settings raised the costs, mostly fuel, per FVC by less than US$1 regardless of the country. Conclusions. This study provides relevant information for donors and decision makers about the cost of implementing RTS,S. Variations within and across countries are important and the unknown future price per dose and wastage rate for this candidate vaccine adds substantially to the uncertainty about the actual costs of implementation

In search of income reference points for SLCA using a country level sustainability benchmark (part 1): fair inequality. A contribution to the Oiconomy project

Purpose: This paper is part 1 of our twin articles on income reference points for Social Life Cycle Assessment (SLCA). Preventative costs based LCA systems, such as the EcoCost system and the Oiconomy system, need targets (performance reference points) to determine the marginal preventative costs, the costs of the most expensive measure that globally needs to be employed to reach the target. To extend the EcoCost system for social issues, targets are required for issues like fair wages and fair inequality of wages, issues for which no agreed standard, no effect level or target exists. One way of setting targets is to take best practices as benchmark, e.g. the practices of a group of best performing countries. The purpose of this part 1 article is to first develop a well-founded benchmark group of the 20 % best performing countries and thereafter propose a well-founded target for the issue of inequality for preventative costs based SLCA, which can also serve as performance reference point for SLCA in general and for other uses. In part 2, for the same purposes and using the same benchmark group, we propose targets for fair minimum wages for every country. Methods: A benchmark group of countries for the setting of targets was determined by an assessment of available country performance indicators, based on 5 criteria. Thereafter, we derived a proposal for a maximum inequality ratio based on existing democratically determined inequality ratios in the benchmark group. Results and discussion: The Sustainable Society Index–Human Wellbeing proved the best indicator for a country benchmark for preventative cost-based SLCA. Using the average of maximum democratically determined income differences in a benchmark group of countries determined by this index, a performance reference point for SLCA for the issue of fair inequality was derived and proposed, resulting in a maximum ratio of income differences for governmental institutions of 14.1, for government ruled companies of 18.3 and for industry of a factor 23.8. Conclusions: It proved possible to derive a target for maximum inequality of wages, based on democratic choices in a benchmark group of the 20 % best performing countries. The target for governmental institutions may be called objective, and proposed augmentations for government ruled companies and industry, though value choices, seem reasonable for the consumer who requires prevention of all possible harm as consequence of his purchase choices and who, as a voter, contributes to governmental standards

Rehabilitation of the Laboratoire de Carbone 14-Dakar (Senegal) with a Super Low-Level Liquid Scintillation Counting System

From the 18th International Radiocarbon Conference held in Wellington, New Zealand, September 1-5, 2003.Following the passing of Prof Cheikh Anta Diop in 1986, the radiocarbon laboratory (LC14) he created 20 yr earlier at the Institut Francophone d'Afrique Noire (IFAN), Dakar, Senegal, fell into a long hibernation. It took nearly 3 yr to renovate the laboratory and reinstall new equipment in order to return LC14 to full functionality and resume its activity. A new dating system has been implemented around a super low-level liquid scintillation spectrometer from Packard, the Tri-Carb 3170TR/LS, located in an underground room. In this paper, we assess the performance of the dating setup (background level and figure of merit) using known samples from Paris 6 and international standards from the International Atomic Energy Agency (IAEA). After the calibration, the setup was used to study bole seashells from the Khant area in the northern part of Senegal (West Africa). The aim is to present evidence of the correlation between the transgression of the Nouakchottan (5500 BP) and a few industries in the Khant area. The corresponding ages are difficult to assess and the dates available for this cultural site are randomly distributed, ranging from 4500 to 1500 BP, i.e., a chronological period spanning from the Neolithic to the Iron Age.The Radiocarbon archives are made available by Radiocarbon and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform February 202

Impact of land use on groundwater quality in the Thiaroye unsewered suburb (Dakar Senegal) : Remote Sensing and GIS approach

Meeting: International Symposium "Coupling Sustainable and Groundwater Protection", 14 - 17 October 2008, Hannove