Les évolutions du travail en milieu hospitalier au Bénin à travers les interventions publiques dans le secteur de la santé de 2018 à 2023

Les interventions publiques dans le secteur de la santé, les cinq dernières années, ont impacté le modèle d'organisation du travail en milieu hospitalier avec un redimensionnement de l'offre sanitaire. L'espace et les heures du travail ont été modifiés et l'offre hospitalière réorganisée avec une restructuration des process de prise en charge des patients. Cette réorganisation du travail hospitalier a engendré une restriction des mouvements syndicaux qui a conduit à une déconstruction des formes de solidarités des professionnels de santé et à une remise en cause des habitudes de production de soins considérées comme surrénales et contre-productives. La mobilisation de nouvelles logiques orientées vers l'optimisation de la prise en charge sanitaire des patients s'est érigée en mode de gouvernance hospitalière fondée sur une réorganisation de la plateforme sanitaire avec comme corollaire une remise en question des réflexes paralégaux. On assiste à une réorganisation des services médicaux et paramédicaux qui a affecté les emplois, les conditions de travail et les relations entre travailleurs et dirigeants hospitaliers. Le présent article restitue une recherche empirique qui vise à analyser les évolutions du travail en milieu hospitalier induites par les actions publiques intervenues entre 2018 et 2023 dans le secteur de la santé béninois. Ces interventions publiques soulèvent bien des interrogations : quelles sont les dynamiques sociales associées aux actions publiques dans le secteur de la santé ? quels sont les facteurs explicatifs des politiques publiques dans la fourniture des services et soins hospitaliers ? quels sont les effets de ces interventions publiques ? Ces préoccupations majeures ont orienté l'enquête suivant trois objectifs : apprécier les logiques sous-jacentes aux actions publiques dans le secteur de santé ; identifier les déterminants liés aux interventions publiques en milieu hospitalier ; inventorier les effets induits par les actions publiques sanitaires. La démarche méthodologique est fondamentalement qualitative. Collectés au moyen d'entretien directif, les corpus ont été analysés suivant la théorie de l’action publique associée à l’approche interactionniste. La restriction de l'espace d'intervention des professionnels de santé, le redimensionnement des rapports de travail sur fond de précarisation de l'emploi induit par une législation contraignante, la réduction des effectifs etc. sont les principaux résultats de l'enquête.   Public interventions in the health sector, the last five years, impacted the model of work organization in the hospital area with a change in health care services. This reorganization of hospital work has caused a restriction of syndical movements, which has led to a deconstruction of solidarity forms of health professionals and to a questioning of care production habits considered adrenal and counterproductive. The mobilization of new logics oriented towards the optimization of patient health care has become a mode of hospital governance based on a reorganization of the health platform, with, as a corollary, a questioning of paralegal reflexes. We witness a disorganization of medical and paramedical services that has affected jobs, work conditions, and relations between workers and hospital managers. This article presents an empirical research which aims to analyze the evolutions of work in the hospital area induced by public actions executed between 2018 and 2023 in the Beninese health sector. These public interventions raise many questions. What are the social dynamics associated with public actions in the health sector? What are the explanatory factors of public actions in the offer of hospital services and care? What are the effects of these public interventions? These major questions guided the investigation, which aims to: appreciate the logic underlying the public actions in the health sector; identify the determinants linked to public interventions in the hospital area; inventory the effects induced by public health actions. The methodological approach is fundamentally qualitative. Collected by a directive interview, the corpora were analyzed according to the theory of public action associated with the interactionist approach. The main results of the survey are: the restriction of the scope of intervention of health professionals, the resizing of employment relationships underground a backdrop of job insecurity induced by restrictive legislation, the reduction of staff, etc

Antibacterial activities of selected edible plants extracts against multidrug-resistant Gram-negative bacteria

BACKGROUND: In response to the propagation of bacteria resistant to many antibiotics also called multi-drug resistant (MDR) bacteria, the discovery of new and more efficient antibacterial agents is primordial. The present study was aimed at evaluating the antibacterial activities of seven Cameroonian dietary plants (Adansonia digitata, Aframomum alboviolaceum, Aframomum polyanthum, Anonidium. mannii, Hibiscus sabdarifa, Ocimum gratissimum and Tamarindus indica). METHODS: The phytochemical screening of the studied extracts was performed using described methods whilst the liquid broth micro dilution was used for all antimicrobial assays against 27 Gram-negative bacteria. RESULTS: The results of the phytochemical tests indicate that all tested extracts contained phenols and triterpenes, other classes of chemicals being selectively present. The studied extracts displayed various degrees of antibacterial activities. The extracts of A. digitata, H. sabdarifa, A. polyanthum, A. alboviolaceum and O. gratissimum showed the best spectra of activity, their inhibitory effects being recorded against 81.48%, 66.66%, 62.96%, 55.55%, and 55.55% of the 27 tested bacteria respectively. The extract of A. polyanthum was very active against E. aerogenes EA294 with the lowest recorded minimal inhibitory concentration (MIC) of 32 μg/ml. CONCLUSION: The results of the present work provide useful baseline information for the potential use of the studied edible plants in the fight against both sensitive and MDR phenotypes

EFFET DU CHARBON ACTIF SUR LA CONSERVATION DE LA VARIETE DE MANIOC (MANIHOT ESCULENTA) RB 89509 MENACEE D’EXTINCTION AU BENIN.

In situ conservation of different cultivars of cassava (Manihot esculenta) implies many problems such as climatic risks, diseases, devastators and financial difficulties. This work contributes to the maintenance of RB 89509 variety of Manihot esculenta through in vitro culture. Two cultures media were used: medium of Murashige and Skoog (MS) and medium of Murashige and Skoog (MS) added with activated carbon. The effects of activated carbon were studied on the growth parameters (number of leaves, number of roots, number of nodes, height of stem, length of internodes, length of principal root) of plantlets aged of twenty months. The results show that the average number of leaves, the average number of nodes and the length of main root are more significant at the plantlets present on medium containing the activated carbon; while the number of roots, the height of stem and the length of internodes are more significant at the plantlets present on medium without activated carbon. Moreover, it is noted an drying of the plantlets on the medium without activated carbon. The activated carbon allowed a better conservation of the plantlets

Caractérisation de l’alimentation des jeunes enfants âgés de 6 à 36 mois en milieu rural et urbain du Sud– Bénin

Objectif: La période d’alimentation complémentaire est une période critique pour la croissance de l’enfant. Cette étude vise à décrire l’alimentation des jeunes enfants âgés de 6 à 36 mois en milieu rural et urbain du Sud-Bénin.Méthodologie et Résultats: Une enquête transversale a été menée sur 600 mères ayant des enfants âgés de 6 à 36 mois dans les zones rurales et urbaines du sud-Bénin, où la prévalence de la malnutrition chronique est élevée (prévalence variant de 40 % à 43 %). Les caractéristiques socio-économiques de la population, les connaissances (définition correcte de l'alimentation complémentaire) et les pratiques (âge d'introduction de l'aliment de complément, les caractéristiques des aliments de complément) ont été documentées. L'analyse en composante principale a été utilisée pour identifier les associations entre les caractéristiques socioéconomiques de la population et les pratiques d’alimentation des jeunes enfants de 6 à 36 mois. Dans l’ensemble, 65% des mères méconnaissent la notion d’alimentation complémentaire. L’introduction précoce des aliments de complément est observée dans 48.5% des cas. La bouillie dans 99.16% des cas est le premier aliment de complément donné aux enfants. Globalement, 67% des mères utilisent des bouillies locales, peu enrichies avec des matières protéiques. La consommation de bouillie issue des farines infantiles vendues dans le commerce est associée au milieu urbain alors que la bouillie locale est associée au milieu rural.Conclusion et application des résultats: Les bouillies locales sont peu enrichies avec des matières protéiques et les fréquences de consommation journalière sont faibles. Ces résultats révèlent l’importance d’améliorer les procédés et formulations traditionnelles des bouillies, stratégies endogènes durables qui méritent d’être encouragées par l’éducation nutritionnelle pour la production de bouillies enrichies à haute valeur nutritionnelle avec des matières premières locales accessibles pour couvrir les besoins nutritionnels et énergétiques des jeunes enfants, gage d’une croissance optimale.Mots clés: Alimentation, enfants de 6 à 36 mois, bouillies, BéninEnglish Title: Characterization of the feeding of young children aged 6 to 36 months in rural and urban areas of the South BeninEnglish AbstractObjective: The period of complementary feeding is a critical period for the growth of the child. This study aims to describe the feeding of young children aged 6 to 36 months in rural and urban areas of the South Benin.Methodology and Results: A cross sectional survey was conducted on 600 mothers having children aged 6 to 36 months in rural and urban areas of the South Benin, where the prevalence of chronic malnutrition is high (prevalence between 40% to 43%). The socio economics data, knowledge (correct definition of complementary feeding) and practices (age of introduction of Complementary Foods, characteristics of Complementary Foods) were collected. Analysis of principal component was used to identify the associations between the socio economics data and feeding practices for 6 to 36 months’ young children. About, 65% of mothers ignore the concept of complementary feeding. The early introduction of complementary foods was observed in 48.5% of cases. Porridge in 99.16% of cases is the first complementary food given to children. Overall, 67% of mothers use local porridges slightly enriched with protein feeds. Porridge based on commercial infant flour consumption is associated with the urban area while local porridge is associated with rural areas.Conclusion and application and results: Local porridge is poorly enriched with protein feeds in rural areas and the frequencies of daily consumption are low. These results reveal the importance of improving the processes and traditional formulations of local porridges. Sustainable strategies that need to be encouraged by mothers ‘nutritional education for the production of enriched porridges with high nutritional value and local raw materials accessible in order to cover the nutritional requirements and energy need of young children, pledge of an optimal growth.Keywords: feeding, children of 6 to 36 months, porridges, Beni

Weight Loss and Nutritional Status of 6-59 Months Children after Positive Deviance/Hearth Approach in Southern Benin Rural Area: Associated Factors to Later Underweight

Aims: To appreciate the evolution of weight gain by malnourished children and factors associated to children underweight after the Positive Deviance/Hearth sessions. Study Design: Longitudinal study. Place and Duration of Study: Districts Ze and Lalo (Southern Benin), from May to August 2014 Methodology: This study was conducted on 98 children aged of 6-59 months who fully participated in Positive Deviance/Hearth (PD/H). During one month, four measurements of weight have been taken on the 77th, 84th, 91th, and 98th day after the beginning of PD/H. Questionnaire was administered to mother on environmental, hygiene practices, and food accessibility of household. Relation among factors of food accessibility, household hygiene, and child nutritional status was sought by an Analysis of Factorial Components. Results: The children who participated in 12 days of PD/H gained significantly 0.63 kg and 1.13 kg of weight in Lalo and Ze respectively (P<.001). From the 12th to 77th day after the end of PD/H, we noticed a significant weight loss from 10.54 to 10.09 kg in Ze and from 9.75 to 9.19 Kg in Lalo (P=.003). Prevalence of underweight children on the 77th day was 45.8% with 12.5% of severe case and 63.5% with 18.9% of severe case in Lalo and Ze, respectively. The severe underweight children were characterized by households where i) it rarely arrived to be without food ii) one member rarely have a day without eaten but iii) the drinking water is from well. Conclusion: On the 77th day after the PD/H, the children of our study had weight loss. Food accessibility and household hygiene are mainly the limited factors that could explain the degradation of the nutritional status of children and high prevalence of underweight. This first study conducted in Benin on PD/H approach is more exploratory and helps to appreciate this approach efficacy and sustainability