Recours aux soins de santé globale et de santé sexuelle et reproductive, chez les étudiants de l’université Houphouët-Boigny, Abidjan, Côte d’Ivoire

Background. – In Ivory Coast, little is known about health needs and health access barriers among young people. The aim of this study was to describe health provision, health needs and barriers when seeking medical care, with an emphasis on sexual and reproductive health, and the acceptability of a medical examination for students attending their first year at the Houphoue¨t-Boigny University, Abidjan, Ivory Coast. Methods. – We conducted a representative cross-sectional study among second year students who were selected by two-stage equiprobable random sampling. In-depth interviews were conducted among students and the university health center staff. Results. – Five hundred and forty three students (322 men and 221 women) answered a questionnaire (participation rate 98.4%). Among women who ever had sex, 38.4% (95%CI [30.5%–47.0%]) had unmet contraception needs and 31.2% [23.7%–40.0%] had experienced an unwanted pregnancy. Fear about impaired fertility was the leading reason for non-use of hormonal contraception, the method of choice among most students. The main health problems among students, by order of frequency were malaria (54.3%), respiratory infection (44.6%), constipation (28.0%) and psychological problems (25.9%). High cost perception of services offered, despite their gratuity, were the main barriers against access to the university health center, indicating a lack of communication about this structure and its services. The majority of students favored the establishment of a medical examination during the first year at the university. Conclusion. – Establishing a medical examination would improve health center visibility. The following services could be offered: (i) HIV, chlamydia and gonorrhea screening, (ii) hepatitis B virus screening and vaccination, (iii) provision and information about contraceptive methods, (iv) presentation of the university health center services. Dedicated spaces where students could have access to information about health-related topics (e.g. sexuality, nutrition, depression) could complete the university’s healthcare offer. # 2017 Elsevier Masson SAS. All rights reserved

Quality of antenatal and delivery care before and after the implementation of a prevention of mother-to-child HIV transmission programme in Côte d'Ivoire.

OBJECTIVE: To assess whether implementation of a prevention of mother-to-child HIV transmission (PMTCT) programme in Côte d'Ivoire improved the quality of antenatal and delivery care services. METHODS: Quality of antenatal and delivery care services was assessed in five urban health facilities before (2002-2003) and after (2005) the implementation of a PMTCT programme through review of facility data; observation of antenatal consultations (n = 606 before; n = 591 after) and deliveries (n = 229 before; n = 231 after) and exit interviews of women; and interviews of health facility staff. RESULTS: HIV testing was never proposed at baseline and was proposed to 63% of women at the first ANC visit after PMTCT implementation. The overall testing rate was 42% and 83% of tested HIV-infected pregnant women received nevirapine. In addition, inter-personal communication and confidentiality significantly improved in all health facilities. In the maternity ward, quality of obstetrical care at admission, delivery and post-partum care globally improved in all facilities after the implementation of the programme although some indicators remained poor, such as filling in the partograph directly during labour. Episiotomy rates among primiparous women dropped from 64% to 25% (P < 0.001) after PMTCT implementation. Global scores for quality of antenatal and delivery care significantly improved in all facilities after the implementation of the programme. CONCLUSIONS: Introducing comprehensive PMTCT services can improve the quality of antenatal and delivery care in general