Increasing Access to Surgical Services in Sub-Saharan Africa: Priorities for National and International Agencies Recommended by the Bellagio Essential Surgery Group

In this Policy Forum, the Bellagio Essential Surgery Group, which was formed to advocate for increased access to surgery in Africa, recommends four priority areas for national and international agencies to target in order to address the surgical burden of disease in sub-Saharan Africa

Chapitre 13. Diversité des processus de valorisation agricole des bas-fonds et durabilité des aménagements au Burkina Faso

Introduction Pour beaucoup, le développement de l’irrigation apparaît comme le meilleur moyen d’augmenter la production agricole, de réduire sa vulnérabilité à la variabilité climatique et d’améliorer les moyens de subsistance au sein des communautés rurales (CILSS, 2010 ; Palé et Da, 2017). Toutefois, à cause du coût d’investissement et de la durabilité incertaine de l’irrigation du fait de problèmes importants de gestion et d’entretien des aménagements (Turral et al., 2010), la question est..

URBAN CITIES AND WASTE GENERATION IN DEVELOPING COUNTRIES: A GIS EVALUATION OF TWO CITIES IN BURKINA FASO

Cities in developing countries are faced waste management challenges in terms of quantity and quality. Most of the time, solid and liquid wastes are dumped on street and open spaces. Uncontrolled waste dumped has led to diverse kind of health problems. The purpose of this article is to characterize urban cities and evaluate their waste generation using the Geographical Info rmation System (GIS). The focus is on two cities in Burkina Faso. Specific variabl es which were considered during the survey include urban fabric, grey water outlets a nd household garbage dumps sites/techniques. The study shows that in the two cities, the most dominant urban fabric is low standard of living (about 64% of housing in Fada and 62% of housing in Pouytenga). The urban fabric is also characterized by the exis tence of empty spaces. Overall, the average density of grey water discharge points is 0.85 points and 5.7 points per ha of street in Fada N’Gourma and Pouytenga respectivel y. The average density of solid waste dumps is 1.45 waste dumps per ha street a nd 7 waste dumps per ha street in Fada N'Gourma and Pouytenga respectively. In case of urgent waste management intervention, the priority areas for speedy intervention are area 10 in Fada N’Gourma, areas 2 and 5 in Pouytenga. GIS applied to w aste management can be a decision making tool for urban planne rs in developing country

Chapitre 18. Adoption des variétés améliorées de riz dans les bas-fonds

Introduction Le secteur du riz fait partie des secteurs qui ont enregistré une croissance phénoménale au cours des vingt dernières années en termes de superficie cultivée, de volume produit et de consommation annuelle par habitant (FAO, 2014). Il occupe la 4e place parmi les céréales cultivées au Burkina Faso, tant du point de vue des superficies, de la production que de la consommation annuelle par tête (MAAH/DGPER, 2016). Cette performance est imputable à plusieurs facteurs, entre autres on..

Risques climatiques et agriculture en Afrique de l’Ouest

Le futur de l’Afrique de l’Ouest dépend de la capacité du secteur de l’agriculture à s’adapter pour garantir la sécurité alimentaire dans un contexte de changement climatique et de croissance démographique. Pour faciliter cette adaptation, la recherche a déployé d’importants efforts pour améliorer les connaissances sur les mécanismes climatiques et leurs impacts sur les systèmes agropastoraux. Or, ces avancées issues de la recherche ne sont que rarement prises en compte dans la planification et la prise de décision. Partant de ce constat, un projet de recherche « Agriculture et gestion des risques climatiques : outils et recherches en Afrique », soutenu par le ministère français des Affaires étrangères et du Développement international est mené entre 2016 et 2018 dans plusieurs pays d’Afrique de l’Ouest. Il a pour objectif d’élaborer des outils efficaces de gestion du risque climatique pour les agriculteurs, en co-construisant avec des réseaux de chercheurs et d’acteurs directement impliqués dans l’accompagnement de l’agriculture des stratégies innovantes basées sur les résultats de la recherche. Cet ouvrage restitue les principales avancées de cette recherche-action sur trois thématiques prioritaires : les services climatiques pour l’agriculture, la gestion des ressources en eau et l’intensification écologique. Il permet aux acteurs du secteur agricole (organisations paysannes, filières, secteur privé agricole, banques de développement agricole, fournisseurs d’intrants, services agricoles et de météorologie) de s’approprier de nouvelles connaissances et de nouveaux outils pour une meilleure prise en compte des risques climatiques dans la gestion des systèmes de production

Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition.

International audienceThe Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age-sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development. We used the published GBD 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate DALYs and HALE for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. We calculated HALE using the Sullivan method; 95% uncertainty intervals (UIs) represent uncertainty in age-specific death rates and YLDs per person for each country, age, sex, and year. We estimated DALYs for 306 causes for each country as the sum of YLLs and YLDs; 95% UIs represent uncertainty in YLL and YLD rates. We quantified patterns of the epidemiological transition with a composite indicator of sociodemographic status, which we constructed from income per person, average years of schooling after age 15 years, and the total fertility rate and mean age of the population. We applied hierarchical regression to DALY rates by cause across countries to decompose variance related to the sociodemographic status variable, country, and time. Worldwide, from 1990 to 2013, life expectancy at birth rose by 6·2 years (95% UI 5·6-6·6), from 65·3 years (65·0-65·6) in 1990 to 71·5 years (71·0-71·9) in 2013, HALE at birth rose by 5·4 years (4·9-5·8), from 56·9 years (54·5-59·1) to 62·3 years (59·7-64·8), total DALYs fell by 3·6% (0·3-7·4), and age-standardised DALY rates per 100 000 people fell by 26·7% (24·6-29·1). For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers, crude rates, and age-standardised rates have all declined between 1990 and 2013, whereas for non-communicable diseases, global DALYs have been increasing, DALY rates have remained nearly constant, and age-standardised DALY rates declined during the same period. From 2005 to 2013, the number of DALYs increased for most specific non-communicable diseases, including cardiovascular diseases and neoplasms, in addition to dengue, food-borne trematodes, and leishmaniasis; DALYs decreased for nearly all other causes. By 2013, the five leading causes of DALYs were ischaemic heart disease, lower respiratory infections, cerebrovascular disease, low back and neck pain, and road injuries. Sociodemographic status explained more than 50% of the variance between countries and over time for diarrhoea, lower respiratory infections, and other common infectious diseases; maternal disorders; neonatal disorders; nutritional deficiencies; other communicable, maternal, neonatal, and nutritional diseases; musculoskeletal disorders; and other non-communicable diseases. However, sociodemographic status explained less than 10% of the variance in DALY rates for cardiovascular diseases; chronic respiratory diseases; cirrhosis; diabetes, urogenital, blood, and endocrine diseases; unintentional injuries; and self-harm and interpersonal violence. Predictably, increased sociodemographic status was associated with a shift in burden from YLLs to YLDs, driven by declines in YLLs and increases in YLDs from musculoskeletal disorders, neurological disorders, and mental and substance use disorders. In most country-specific estimates, the increase in life expectancy was greater than that in HALE. Leading causes of DALYs are highly variable across countries. Global health is improving. Population growth and ageing have driven up numbers of DALYs, but crude rates have remained relatively constant, showing that progress in health does not mean fewer demands on health systems. The notion of an epidemiological transition--in which increasing sociodemographic status brings structured change in disease burden--is useful, but there is tremendous variation in burden of disease that is not associated with sociodemographic status. This further underscores the need for country-specific assessments of DALYs and HALE to appropriately inform health policy decisions and attendant actions. Bill & Melinda Gates Foundation