Use of GIS as a Tool for Integrated Water Resources Management in the City of Parakou, Benin

Water, a source of life, is the habitat, food, means of production and transportation and is threatened by irregular rainfall and evaporation. The objective of this study is to contribute with the help of GIS to a better management of water resources in the city of Parakou. To achieve this objective, the methodological approach was based on the collection, processing and analysis of data through the SWOT model. The sample consisted of 109 individuals distributed in the three districts of the city of Parakou. The study revealed that the water resources available in the city of Parakou are of three types (rainwater, surface water and groundwater). These resources are constantly decreasing due to the downward trend in rainfall with a slope of -3.99mm. In addition, the growing population with a growth rate (4.9%) from 2002 to 2013 and the poor use of these resources influence its availability. The unequal distribution of waterworks (58.94%) for the first arrondissement and 41.06% for the other two coupled arrondissements, as well as the unequal distribution of water from the Société Nationale des Eaux du Bénin (SONEB) lead to difficulty in accessing water. Under these conditions, the populations are developing various measures to adapt to the situation. These measures are related to the subscription of households to public water services, the purchase of drinking water, water treatment and water conservation. Given the effectiveness of the measures identified and their limitations, it is important that decision-makers develop a sectoral policy encompassing the construction of water supply infrastructure, better management of structures and support for the reorganization of the drinking water sector

Reproductive Performance of Glossina palpalis gambiensis (Diptera: Glossinidae) when fed frozen or fresh bovine blood meals

The tsetse and trypanosomoses control by sterile insect technique (SIT), requires mass production of quality tsetse pupae and consequently high-quality blood meal for the fly feeding. The reproductive performances of Glossina palpalis gambiensis (Diptera : Glossinidae), fed frozen or fresh blood meals has been studied. Three diets of slaughtered bovine blood stored at -18 °C for six months (R6), three months (R3) and one month (R1) were used in the present investigation. Fresh blood samples stored at 4°C and renewed every four days were used as control (R0). The defibrinated blood was packaged in batches of 30 x 20 ml vials. For each blood meal, 30-day feeding tests were conducted at the beginning and end of freezing. All blood meal was irradiated using 137 caesium irradiation before being used. The parameters monitored daily were: the number of dead flies (fed and unfed), the number and weight of pupae and the emergence rate. No difference in survival rates was observed for the three regimes (df: 15; Chi-square: 7.53; p > 0.05), on average 32.1% (R0), 32.4% (R6), 37.5% (R3) and 38.2% (R1). However, flies fed with the six-month-old frozen blood were less efficient in pupa production (df: 3; F: 6. p < 0.001) and pupae weight (df: 3, F: 3.24, p < 0.05) compared to the control. The mortality rate was affected by the duration of freezing: 26.7% for R6 and 8% for the other diets (p <0.05). The implications of our results in terms of blood meal management for efficient production of insectary pupae were discussed

How a supply‐side intervention can help to increase caesarean section rates in Burkina Faso facilities—Evidence from an interrupted time‐series analysis using routine health data

Objectives: In Burkina Faso, only 2.1% of women give birth by caesarean section (CS). To improve the use of maternal health services during pregnancy and childbirth, many interventions were implemented during the 2010s including performance‐based financing (PBF) and a free maternal health care policy (the gratuité). The objective of this study is to evaluate the impact of a supply‐side intervention (PBF) combined with a demand‐side intervention (gratuité) on institutional CS rates in Burkina Faso. Methods: We used routine health data from all the public health facilities in 21 districts (10 that implemented PBF and 11 that did not) from January 2013 to September 2017. We analysed CS rates as the proportion of CS performed out of all facility‐based deliveries (FBD) that occurred in the district. We performed an interrupted time series (ITS) analysis to evaluate the impact of PBF alone and then in conjunction with the gratuité on institutional CS rates. Results: CS rates in Burkina Faso increased slightly between January 2013 and September 2017 in all districts. After the introduction of PBF, the increase of CS rates was higher in intervention than in non‐intervention districts. However, after the introduction of the gratuité, CS rates decreased in all districts, independently of the PBF intervention. Conclusion: In 2017, despite high FBD rates in Burkina Faso as well as the PBF intervention and the gratuité, less than 3% of women who gave birth in a health facility did so by CS. Our study shows that the positive PBF effects were not sustained in a context of user fee exemption

How a supply-side intervention can help to increase caesarean section rates in Burkina Faso facilities-Evidence from an interrupted time-series analysis using routine health data.

OBJECTIVES: In Burkina Faso, only 2.1% of women give birth by caesarean section (CS). To improve the use of maternal health services during pregnancy and childbirth, many interventions were implemented during the 2010s including performance-based financing (PBF) and a free maternal health care policy (the gratuité). The objective of this study is to evaluate the impact of a supply-side intervention (PBF) combined with a demand-side intervention (gratuité) on institutional CS rates in Burkina Faso. METHODS: We used routine health data from all the public health facilities in 21 districts (10 that implemented PBF and 11 that did not) from January 2013 to September 2017. We analysed CS rates as the proportion of CS performed out of all facility-based deliveries (FBD) that occurred in the district. We performed an interrupted time series (ITS) analysis to evaluate the impact of PBF alone and then in conjunction with the gratuité on institutional CS rates. RESULTS: CS rates in Burkina Faso increased slightly between January 2013 and September 2017 in all districts. After the introduction of PBF, the increase of CS rates was higher in intervention than in non-intervention districts. However, after the introduction of the gratuité, CS rates decreased in all districts, independently of the PBF intervention. CONCLUSION: In 2017, despite high FBD rates in Burkina Faso as well as the PBF intervention and the gratuité, less than 3% of women who gave birth in a health facility did so by CS. Our study shows that the positive PBF effects were not sustained in a context of user fee exemption

How a supply‐side intervention can help to increase caesarean section rates in Burkina Faso facilities—Evidence from an interrupted time‐series analysis using routine health data

Objectives: In Burkina Faso, only 2.1% of women give birth by caesarean section (CS). To improve the use of maternal health services during pregnancy and childbirth, many interventions were implemented during the 2010s including performance-based financing (PBF) and a free maternal health care policy (the gratuité). The objective of this study is to evaluate the impact of a supply-side intervention (PBF) combined with a demand-side intervention (gratuité) on institutional CS rates in Burkina Faso. Methods: We used routine health data from all the public health facilities in 21 districts (10 that implemented PBF and 11 that did not) from January 2013 to September 2017. We analysed CS rates as the proportion of CS performed out of all facility-based deliveries (FBD) that occurred in the district. We performed an interrupted time series (ITS) analysis to evaluate the impact of PBF alone and then in conjunction with the gratuité on institutional CS rates. Results: CS rates in Burkina Faso increased slightly between January 2013 and September 2017 in all districts. After the introduction of PBF, the increase of CS rates was higher in intervention than in non-intervention districts. However, after the introduction of the gratuité, CS rates decreased in all districts, independently of the PBF intervention. Conclusion: In 2017, despite high FBD rates in Burkina Faso as well as the PBF intervention and the gratuité, less than 3% of women who gave birth in a health facility did so by CS. Our study shows that the positive PBF effects were not sustained in a context of user fee exemption

Does hospital variation in intrapartum-related perinatal mortality among caesarean births reflect differences in quality of care? Cross-sectional study in 21 hospitals in Burkina Faso

OBJECTIVES: To examine hospital variation in crude and risk-adjusted rates of intrapartum-related perinatal mortality among caesarean births. DESIGN: Secondary analysis of data from the DECIDE (DECIsion for caesarean DElivery) cluster randomised trial postintervention phase. SETTING: 21 district and regional hospitals in Burkina Faso. PARTICIPANTS: All 5134 women giving birth by caesarean section in a 6-month period in 2016. PRIMARY OUTCOME MEASURE: Intrapartum-related perinatal mortality (fresh stillbirth or neonatal death within 24 hours of birth). RESULTS: Almost 1 in 10 of 5134 women giving birth by caesarean experienced an intrapartum-related perinatal death. Crude mortality rates varied substantially from 21 to 189 per 1000 between hospitals. Variation was markedly reduced after adjusting for case mix differences (the median OR decreased from 1.9 (95% CI 1.5 to 2.5) to 1.3 (95% CI 1.2 to 1.7)). However, higher and more variable adjusted mortality persisted among hospitals performing fewer caesareans per month. Additionally, adjusting for caesarean care components did not further reduce variation (median OR=1.4 (95% CI 1.2 to 1.8)). CONCLUSIONS: There is a high burden of intrapartum-related perinatal deaths among caesarean births in Burkina Faso and sub-Saharan Africa more widely. Variation in adjusted mortality rates indicates likely differences in quality of caesarean care between hospitals, particularly lower volume hospitals. Improving access to and quality of emergency obstetric and newborn care is an important priority for improving survival of babies at birth. TRIAL REGISTRATION NUMBER: ISRCTN48510263

Factors Predictive of the Level Of Physical Activity (PA) in Patients with Gonarthrosis in Sub-Saharan Africa

Background: Our aim was to determine the predictive factors of the level of physical activity (PA) in patients with gonarthrosis in the city of Ouagadougou (Burkina Faso). Methods: This was a cross-sectional, descriptive and analytical study based on clinical records, conducted from January 9 to 27, 2023. Using the International Physical Activity Questionnaire (IPAQ), we assessed the level of PA in patients followed at CHU-Bogodogo for gonarthrosis. The significance threshold p<0.05 was retained. Results: Sixty-seven patients were included. Fifty-six were women (83.58%). The mean age was 59.87± 12.53 years. Hypertension was noted in 34 patients (50.75%), diabetes in 16 (23.88%). The mean BMI was 28.70kg/m2± 6.73. Gonarthrosis was bilateral in 49 patients (73.13%). Gonarthrosis patients had a moderate level of PA, with a mean IPAQ score equal to 635.24±135 MET-minutes/week. 45 patients (67.16%) had a low level of physical activity (˂ 600 MET-minutes/week). In bivariate analysis, low PA was associated with age over 65 [OR=5.62, (CI=1.45-21.73), p<0.001], hypertension [OR=2.83, (CI=1.27-6.31), p<0.001], diabetes [OR=2.14, (CI=1.13-5.89), p<0.031], and overweight [OR=2.43, (CI=1.17-6.12), p<0.026]. Moderate PA was associated with age under 65 [OR=1.71, (CI=1.25-2.34), p<0.005] and absence of hypertension [OR=1.86, (CI=1.19-2.89), p<0.012]. Conclusion : Gonarthrosis patients have a moderate level of PA. Factors associated with low PA were advanced age and sedentary comorbidities. Key words: Gonarthrosis, physical activity, Ouagadougou/Burkina Fas

A research agenda to improve incidence and outcomes of assisted vaginal birth

Access to emergency obstetric care, including assisted vaginal birth and caesarean birth, is crucial for improving maternal and childbirth outcomes. However, although the proportion of births by caesarean section has increased during the last few decades, the use of assisted vaginal birth has declined. This is particularly the case in low- and middle-income countries, despite an assisted vaginal birth often being less risky than caesarean birth. We therefore conducted a three-step process to identify a research agenda necessary to increase the use of, or reintroduce, assisted vaginal birth: after conducting an evidence synthesis, which informed a consultation with technical experts who proposed an initial research agenda, we sought and incorporated the views of women's representatives of this agenda. This process has allowed us to identify a comprehensive research agenda, with topics categorized as: (i) the need to understand women's perceptions of assisted vaginal birth, and provide appropriate and reliable information; (ii) the importance of training health-care providers in clinical skills but also in respectful care, effective communication, shared decision-making and informed consent; and (iii) the barriers to and facilitators of implementation and sustainability. From women's feedback, we learned of the urgent need to recognize labour, childbirth and postpartum experiences as inherently physiological and dignified human processes, in which interventions should only be implemented if necessary. The promotion and/or reintroduction of assisted vaginal birth in low-resource settings requires governments, policy-makers and hospital administrators to support skilled health-care providers who can, in turn, respectfully support women in labour and childbirth. [Abstract copyright: (c) 2023 The authors; licensee World Health Organization.

Déterminants de la césarienne de qualité en Afrique de l'Ouest

In Burkina Faso, the national caesarean section rate is still low (2% in 2012). However, since the introduction of caesarean user fee exemption in 2006 and the availability of trained staff to perform a caesarean section in the most remote hospitals, the institutional caesareans rates have risen steadily and it is unclear whether all of these interventions are necessary. The main objective of this thesis is to identify the determinants of an optimal practice of caesarean section in three western African countries that favour access to caesarean section. The results of the work carried out in the framework of this thesis show that the level of qualification of the health personnel working in Burkina Faso hospitals and his professional experience determine globally his level of knowledge in the management of labor and complicated childbirth. . In addition, regular supervision of his work by daily review of clinical records (partograms) seems to improve his performance. The level of qualification of health personnel in Burkina Faso also influences the practice of non-medically justified caesareans. But the social environment also plays a role in this abusive practice. The results of this research show that the systematic practice of cesarean section after an anterior caesarean section is not justified in this context. The results of this thesis led to the development and implementation of a multi-faceted intervention trial aimed at reducing caesareans without medical reason in West Africa.Au Burkina Faso, le taux populationnel de césariennes reste encore faible (2% en 2012). Cependant, depuis l’exemption partielle (80%) pour les familles du paiement à l’acte en 2006, et la mise à disposition de médecins généralistes, sages-femmes et infirmiers formés à la pratique des césariennes dans les hôpitaux les plus reculés, on observe une augmentation constante des taux de césariennes dans les établissements de santé et il est difficile de savoir si toutes ces interventions sont réellement utiles. L’objectif principal de cette thèse est d’identifier les déterminants d’une césarienne de qualité en Afrique de l’Ouest pour orienter les politiques de santé reproductive dans les pays concernés. Les résultats des travaux menés dans le cadre de cette thèse montrent que le niveau de qualification du personnel de santé travaillant dans les hôpitaux du Burkina Faso et son expérience professionnelle déterminent globalement son niveau de connaissance en matière de gestion du travail et de l’accouchement compliqué. De plus, une supervision régulière de son travail semble améliorer sa performance. Le niveau de qualification du personnel de santé au Burkina Faso influence également la pratique de césariennes non médicalement justifiées. Mais l’environnement social joue aussi un rôle dans cette pratique abusive. Les résultats de cette recherche montrent enfin que la pratique systématique d’une césarienne après une césarienne antérieure n’est pas justifiée dans ce contexte. Les résultats de cette thèse ont permis de développer et de mettre en œuvre un essai d’intervention visant à réduire des césariennes sans raison médicale en Afrique de l’ouest

Utilization and quality of postpartum services for mother and infant in Kaya health district (Burkina Faso)

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