Vulnerability and ageing in Ouagadougou: The crucial role of gender and migration status in older people’s support

AbstractThe issue of care for older people brings up a number of concerns in African cities, which are characterized by rapid urban growth, economic crisis, transformation in social relationships, and the near absence of institutional support for older people. Based on quantitative and qualitative data collected through the Ouagadougou Health and Demographic Surveillance System (Ouagadougou HDSS, 2010-2017), this article examines the situation of older men and women living in the capital of Burkina Faso, whether they have always lived there or moved there from elsewhere. It aims to better understand the vulnerabilities of these older people, what becomes of them over time, and the issues and family dynamics that surround them. The results highlight important differences according to the sex and migration status of older people as determinants of vulnerabilities and emphasize the role in their care played by the sociocultural context.RésuméLa problématique de la prise en charge des personnes âgées suscite de nombreuses inquiétudes dans les villes africaines, caractérisées par une urbanisation rapide, la crise économique, la transformation des rapports sociaux, et la quasi inexistencede l’assistance institutionnelle aux personnes âgées. A partir de données quantitatives et qualitatives collectées dans l’Observatoire de Population de Ouagadougou, cet article s’intéresse à la situation et au devenir des hommes et femmes âgées vivant dans la capitale du Burkina Faso, qu’ils y vivent depuis toujours ou qu’ils y soient arrivés plus ou moins récemment. Il vise à mieux connaître leurs vulnérabilités, ce qu’elles deviennent au fil du temps, ainsi que les enjeux et les dynamiques familiales qui se mettent en place autour d’elles. Les résultats soulignent des différences importantes selon le sexe et le statut migratoire des personnes âgées, etmettent en évidence le rôle du contexte socio-culturel dans leur prise en charge

The dynamic role of household structure on under-5 mortality in southern and eastern sub-Saharan Africa

Background: Children are born and grow up in households, where they receive essential care, including time, socio-psychological support, and economic resources. Children's immediate environment, captured by household structure, changes over time. Objective: We evaluate the role of dynamic household structure in the risk of child death in southern and eastern Africa. Methods: We use longitudinal data from 15 Health and Demographic Surveillance Systems between 1990 and 2016, covering almost 282,000 under-5 year olds. We analyse under-5 mortality using semi-parametric Cox models accounting for time-varying household structure (household size and household typology) and controlling for maternal characteristics. Results: We find that children in smaller households have a higher risk of death than those in large households. In particular, children in households where they are the sole child with two adults of opposite sexes have the lowest chances of survival, reflecting a first-child effect. By contrast, nuclear-type households with more than one child are the most protective, while children in extended households are more vulnerable. Contribution: Our findings suggest that the (in)stability of households is important in evaluating child survival, and that it is imperative to consider households as changing entities

A Theoretical Analysis of the Geography of Schistosomiasis in Burkina Faso Highlights the Roles of Human Mobility and Water Resources Development in Disease Transmission

We study the geography of schistosomiasis across Burkina Faso by means of a spatially explicit model of water-based disease dynamics. The model quantitatively addresses the geographic stratification of disease burden in a novel framework by explicitly accounting for drivers and controls of the disease, including spatial information on the distributions of population and infrastructure, jointly with a general description of human mobility and climatic/ecological drivers. Spatial patterns of disease are analysed by the extraction and the mapping of suitable eigenvectors of the Jacobian matrix subsuming the stability of the disease-free equilibrium. The relevance of the work lies in the novel mapping of disease burden, a byproduct of the parametrization induced by regional upscaling, by model-guided field validations and in the predictive scenarios allowed by exploiting the range of possible parameters and processes. Human mobility is found to be a primary control at regional scales both for pathogen invasion success and the overall distribution of disease burden. The effects of water resources development highlighted by systematic reviews are accounted for by the average distances of human settlements from water bodies that are habitats for the parasite's intermediate host. Our results confirm the empirical findings about the role of water resources development on disease spread into regions previously nearly disease-free also by inspection of empirical prevalence patterns. We conclude that while the model still needs refinements based on field and epidemiological evidence, the proposed framework provides a powerful tool for large-scale public health planning and schistosomiasis management

Dynamiques familiales et santé des enfants : perspectives longitudinales en Afrique de l'Ouest

In the past, African family are mostly considered as a stable institution. However, presently, the African family is a changing institution where the composition and structure are largely affected by the life trajectories caused by economic, sociopolitical and demographic dynamics. In a context where the family unit is the only institution that ensures well-being because of the lack of an efficient social security system and the insufficiency of public health services, these perturbations have an influence on the family’s ability to provide care to its most vulnerable members, especially children and the elderly. This thesis on family dynamics and child health in West Africa examines the consequences of this permanent family instability. Based on a longitudinal approach using data from five Health and Demographic surveillance systems located in Burkina Faso (Ouagadougou and Nanoro), Senegal (Niakhar and Mlomp) and The Gambia (Farafenni), it revisits the family environment from the children’s point of view and examines its influence on health via immunization and under 5 mortality.(POLS - Sciences politiques et sociales) -- UCL, 202

Inégalités de mortalité néonatale entre quartiers formels et informels à Ouagadougou (Burkina Faso) : éclairage à partir des données de l’observatoire de population de Ouagadougou

Dans un contexte d’expansion rapide des quartiers informels dans les villes de l’Afrique Sub-saharienne, cette recherche vise à saisir l’influence du type de quartier (formel/informel) sur la mortalité néonatale à Ouagadougou, capitale du Burkina Faso. L’analyse s’appuie sur les données collectées dans l’Observatoire de Population de Ouagadougou (OPO) sur la période 2009-2018. Les résultats obtenus grâce au modèle de Cox mettent en évidence une surmortalité néonatale dans les quartiers informels. En plus du type de quartier, des variations significatives de la mortalité néonatale selon le type d’accouchement, le poids à la naissance, la gémellité et les intervalles intergénésiques sont mises en évidence. L’amélioration de l’offre sanitaire dans les quartiers informels, le renforcement des programmes existants de planification familiale, la sensibilisation sur les comportements prénatals et postnatals dans ces quartiers sont des préalables à la baisse de la mortalité néonatale à Ouagadougou

Vulnerability and ageing in Ouagadougou. The crucial role of gender and migration status in older people’s support

International audienceThe issue of care for older people brings up a number of concerns in African cities, which are characterized by rapid urban growth, economic crisis, transformation in social relationships, and the near absence of institutional support for older people. Based on quantitative and qualitative data collected through the Ouagadougou Health and Demographic Surveillance System (Ouagadougou HDSS, 2010-2017), this article examines the situation of older men and women living in the capital of Burkina Faso, whether they have always lived there or moved there from elsewhere. It aims to better understand the vulnerabilities of these older people, what becomes of them over time, and the issues and family dynamics that surround them. The results highlight important differences according to the sex and migration status of older people as determinants of vulnerabilities and emphasize the role in their care played by the sociocultural context.RésuméLa problématique de la prise en charge des personnes âgées suscite de nombreuses inquiétudes dans les villes africaines, caractérisées par une urbanisation rapide, la crise économique, la transformation des rapports sociaux, et la quasi inexistencede l’assistance institutionnelle aux personnes âgées. A partir de données quantitatives et qualitatives collectées dans l’Observatoire de Population de Ouagadougou, cet article s’intéresse à la situation et au devenir des hommes et femmes âgées vivant dans la capitale du Burkina Faso, qu’ils y vivent depuis toujours ou qu’ils y soient arrivés plus ou moins récemment. Il vise à mieux connaître leurs vulnérabilités, ce qu’elles deviennent au fil du temps, ainsi que les enjeux et les dynamiques familiales qui se mettent en place autour d’elles. Les résultats soulignent des différences importantes selon le sexe et le statut migratoire des personnes âgées, etmettent en évidence le rôle du contexte socio-culturel dans leur prise en charge

The patterns of disability in the peripheral neighborhoods of Ouagadougou, Burkina Faso, and the male–female health-survival paradox

Disability is a crucial health and social concern in sub-Saharan Africa, where a high prevalence of disabling diseases is compounded with insufficient care provision. There is a need for detailed analysis of the disability patterns. We provide a gender-specific picture for the population in peripheral Ouagadougou (Burkina-Faso), based on six disability dimensions following the United Nations’ recommendations. We computed disability-free life expectancy (LE) using the Health and Demographic Surveillance System (Ouaga HDSS) (n = 1 902). Women have a longer partial LE in the 20–79 age range (+3.3 years), half of this LE being spent with a disability, versus 31% of the LE for men. Limitations in mobility, cognition, and eyesight occur in midadulthood and result in a considerable disadvantage for women in the number of years with these limitations. These findings highlight disability patterns that are detrimental to social participation and claim for better screening and care, especially for women

Dynamic household structure and composition: a manual for longitudinal analysis of living arrangements

Abstract Objective This research note introduces a set of tools to conduct analysis of household structure and composition with either limited or comprehensive longitudinal data. The data used here are from Health and Demographic Surveillance Systems in Africa, but the methods can be adapted and applied to other longitudinal micro-data such as register data. A training manual describing the procedures for creating time-varying household measures step-by-step is supplied as supplementary material to this note. Code is provided in STATA but can easily be translated for other statistical software, and the logic for each step remains the same. Results The analysis of household structure demonstrates how with limited data (such as a household identifier), it is possible to construct time-varying measures of household membership, including household size or the number of members in specific age and sex groups. The analysis of household composition demonstrates how with expanded data (including links to parents in addition to residence status in the same household), it is possible to construct time-varying measures of household membership of specific kin, i.e. mother, sibling or grandparent. The results illustrated in this research note are a taste of what can be achieved by following the training manual in the supplementary material

Surmortalité des enfants dans les quartiers informels de Ouagadougou : effet de composition ou effet de contexte ?

En Afrique sub-saharienne, les auteurs cherchant à expliquer la surmortalité des enfants des quartiers informels ont rarement essayé de dissocier les caractéristiques sociodémographiques des parents, d’une part, et les effets de contexte, d’autre part, en utilisant une définition « locale » de ces quartiers. Le différentiel de mortalité entre les quartiers formels et informels de la capitale du Burkina Faso est analysé ici à l’aide des données de l’Observatoire de Population de Ouagadougou. Les analyses reposent sur le calcul des taux de mortalité, et sur le modèle de régression de Cox. Au-delà des effets de l’instruction de la mère, de l’âge de la mère, et du niveau de vie du ménage, la résidence dans les quartiers informels est positivement associée à la mortalité des enfants. L’amélioration des conditions sanitaires dans ces quartiers, et un meilleur accès aux services de santé sont deux préalables à la baisse de la mortalité des enfants