Scoping review of the literature on the abolition of user fees in health care services in Africa

Published in association with The London School of Hygiene and Tropical MedicineTwenty studies were selected for analysis of effects of the abolition of user fees in sub-Saharan health care services. Results of the scoping review showed that generally this has had positive effects on the utilization of health services. However, while the literature findings demonstrate positive effects, they also highlight the importance of implementation processes, context, and gaps in information. There is a scarcity of data regarding implementation procedures, and there is a need for further research in this area. Political will should include a commitment to planning implementation processes

Evaluating quality of obstetric care in low-resource settings: Building on the literature to design tailor-made evaluation instruments - an illustration in Burkina Faso

<p>Abstract</p> <p>Background</p> <p>There are many instruments available freely for evaluating obstetric care quality in low-resource settings. However, this profusion can be confusing; moreover, evaluation instruments need to be adapted to local issues. In this article, we present tools we developed to guide the choice of instruments and describe how we used them in Burkina Faso to facilitate the participative development of a locally adapted instrument.</p> <p>Methods</p> <p>Based on a literature review, we developed two tools: a conceptual framework and an analysis grid of existing evaluation instruments. Subsequently, we facilitated several sessions with evaluation stakeholders in Burkina Faso. They used the tools to develop a locally adapted evaluation instrument that was subsequently tested in six healthcare facilities.</p> <p>Results</p> <p>Three outputs emerged from this process:</p> <p>1) A comprehensive conceptual framework for the quality of obstetric care, each component of which is a potential criterion for evaluation.</p> <p>2) A grid analyzing 37 instruments for evaluating the quality of obstetric care in low-resource settings. We highlight their key characteristics and describe how the grid can be used to prepare a new evaluation.</p> <p>3) An evaluation instrument adapted to Burkina Faso. We describe the experience of the Burkinabé stakeholders in developing this instrument using the conceptual framework and the analysis grid, while taking into account local realities.</p> <p>Conclusions</p> <p>This experience demonstrates how drawing upon existing instruments can inspire and rationalize the process of developing a new, tailor-made instrument. Two tools that came out of this experience can be useful to other teams: a conceptual framework for the quality of obstetric care and an analysis grid of existing evaluation instruments. These provide an easily accessible synthesis of the literature and are useful in integrating it with the context-specific knowledge of local actors, resulting in evaluation instruments that have both scientific and local legitimacy.</p

Recension des écrits scientifiques sur l'abolition des frais aux usagers dans les services de santé en Afrique : document de travail

For detecting weak signals (when their amplitude is comparable with the amplitude of the noise track) a new class of transformations of random series to a straight line has been suggested. It has been shown that these transformations are quasi-linear and can be defined as a signal-to-staircase transformation (SST). The height of a step defines an amplitude of the detected signal and the step length its duration. The SST can be applicable for a wide class of random series having different statistical nature. The verification of this new method based on the analysis of the real signal/noise tracks containing registration of different earthquakes with small amplitudes has been realized. It has also been shown that different situations which have been found from the real-data analysis demonstrate the high sensitivity and efficiency of the new method suggested

Open Access Developing a tool to measure satisfaction among health professionals in sub-Saharan Africa

Background: In sub-Saharan Africa, lack of motivation and job dissatisfaction have been cited as causes of poor healthcare quality and outcomes. Measurement of health workers ’ satisfaction adapted to sub-Saharan African working conditions and cultures is a challenge. The objective of this study was to develop a valid and reliable instrument to measure satisfaction among health professionals in the sub-Saharan African context. Methods: A survey was conducted in Senegal and Mali in 2011 among 962 care providers (doctors, midwives, nurses and technicians) practicing in 46 hospitals (capital, regional and district). The participation rate was very high: 97 % (937/962). After exploratory factor analysis (EFA), construct validity was assessed through confirmatory factor analysis (CFA). The discriminant validity of our subscales was evaluated by comparing the average variance extracted (AVE) for each of the constructs with the squared interconstruct correlation (SIC), and finally for criterion validity, each subscale was tested with two hypotheses. Two dimensions of reliability were assessed: internal consistency with Cronbach’s alpha subscales and stability over time using a test-retest process. Results: Eight dimensions of satisfaction encompassing 24 items were identified and validated using a process that combined psychometric analyses and expert opinions: continuing education, salary and benefits, management style, tasks, work environment, workload, moral satisfaction and job stability. All eight dimensions demonstrate

La fabrique des sociétés médiévales méditerranéennes

Définir toujours plus finement les contours des sociétés médiévales et les hiérarchies qui les traversent, mettre en lumière leurs stratégies économiques, scripturaires et politiques en valorisant l’agency des individus, tels sont les champs embrassés par François Menant ces quarante dernières années. Le crédit, les conjonctures de crise et les réponses qu’y apportent les sociétés urbaines et rurales, leur litteracy et leur communication politique sont autant de thèmes sur lesquels cet ouvrage a l’ambition d’offrir un panorama actualisé. Couvrant un large arc chronologique, du haut Moyen Âge à la Renaissance, dans un espace européen généralement orienté autour de la Méditerranée, ce livre collectif a également vocation à retracer les vastes réseaux scientifiques internationaux tissés par François Menant au cours de sa carrière : anciens élèves de l’École normale supérieure de Paris, maîtres de conférence, professeurs des universités, venus de France, d’Europe ou des Amériques offrent ainsi un instantané de la recherche en histoire économique et sociale actuelle. De l’individu au groupe, de la figure de l’entrepreneur médiéval aux élites rurales, de François Menant à ses élèves et à ses collègues, tel est le chemin que permettra de parcourir cette étude