Le comportement de recherche d’information en santé sexuelle et reproductive via Internet chez les adolescent-e-s de 15 à 19 ans au Burkina Faso

Cette thèse examine les déterminants de la recherche d'information en santé sexuelle et reproductive (SSR) via Internet chez les adolescent-e-s âgé-e-s de 15 à 19 ans au Burkina Faso en se focalisant sur deux problématiques de santé : les grossesses non désirées et les infections transmissibles sexuellement et par le sang (ITSS). Sur le plan théorique, la thèse s'appuie sur un cadre théorique intégrateur. Ce modèle combine différentes variables issues de la théorie du comportement planifié, de la théorie du comportement interpersonnel et du modèle de recherche et de traitement d'information sur les risques. Il est utilisé pour expliquer l'intention de recherche d'information sur les grossesses non désirées et les ITSS via Internet chez ces adolescent-e-s. L'étude comportait d'abord un premier volet méthodologique qui a permis (i) d'identifier les croyances saillantes et modales des adolescent-e-s, (ii) d'évaluer la compréhension du questionnaire et (iii) de vérifier les qualités psychométriques de celui-ci. Le questionnaire final a été conçu à la suite des ajustements réalisés lors de ce volet de validation du questionnaire. Le second volet, qui est l'étude principale, a permis de collecter des informations sur les facteurs pouvant affecter la recherche d'information en SSR via Internet chez les adolescent-e-s concernant les grossesses non désirées et les ITSS. Au total, 730 adolescent-e-s ont participé à l'étude principale, dont 363 répondants pour le questionnaire portant sur les grossesses non désirées et 367 pour le questionnaire portant sur les ITSS. Dans le but d'identifier les déterminants de l'intention de recherche d'information via Internet sur les grossesses non désirées et les ITSS chez ces adolescent-e-s, plusieurs modèles d'analyses logistiques multivariées, stratifiés selon le sexe et selon la problématique de SSR (grossesses non désirées et ITSS), ont été estimés. Les résultats ont révélé que les facteurs déterminant l'intention de recherche d'information en SSR via Internet diffèrent selon le sexe et selon la problématique de SSR. Concernant l'intention de recherche d'information via Internet sur les grossesses non désirées, la variance expliquée du modèle final est de 38 % pour les garçons et 37,9 % pour les filles. Chez les garçons, les principaux déterminants de l'intention de recherche d'information via Internet sur les grossesses non désirées sont l'attitude cognitive (RC = 4,6; IC95% : 1,70 - 12,21), le comportement passé (RC = 5,5; IC95% : 1,93 - 15,85) et la norme subjective (RC = 3,2; IC95% : 1,34 - 7,43). Pour les filles, c'est l'attitude cognitive (RC = 23,3; IC95% : 2,40 - 32,68) qui apparaît comme le déterminant principal de l'intention. Concernant l'intention de recherche d'information via Internet sur les ITSS, la variance expliquée du modèle final est de 40,17 % pour les garçons et 33,28 % pour les filles. Chez les garçons, les principaux déterminants de l'intention de recherche d'information sur les ITSS via Internet sont l'attitude cognitive (RC = 6,8; IC95% : 2,13 - 21,46), l'attitude affective (RC = 3,6; IC95% : 1,42 - 9,14) et le comportement passé (RC = 3,3; IC95% : 1,19 - 9,10). Pour les filles, seulement des tendances statistiques ont été observées dans le modèle de prédiction de l'intention de recherche d'information en ligne sur les ITSS. Au regard de ces résultats, les stratégies de communication en santé visant à renforcer la recherche d'information en SSR via Internet par les adolescent-e-s au Burkina Faso devraient être ajustées pour intégrer ces déterminants afin d'améliorer leur efficacité. Bien que les résultats de cette thèse soutiennent des actions possibles en communication, l'amélioration de la SSR des adolescents au Burkina Faso impliquera une approche globale et intégrée de santé publique.This thesis investigates the determinants of online information seeking about sexual and reproductive health (SRH) among adolescents aged 15-19 years in Burkina Faso by focusing on two health issues: unwanted pregnancies and sexually transmitted and blood-borne infections (STBBIs). Theoretically, the study is built on an integrative framework. This model combines variables from the planned behaviour theory, the interpersonal behaviour theory and the risk information search and processing model. It is used to explain the intention to seek information on unwanted pregnancy and STBBIs via the online among these adolescents. The study began with an initial methodological phase that enabled us to (i) identify adolescents' modal salient beliefs (ii) evaluate the questionnaires' comprehensibility and (iii) check its psychometric qualities. The final questionnaires were created based on adjustments made during this first phase. The second phase, which is the main study, collected information on factors affecting adolescents' online information seeking on unwanted pregnancies and STBBIs. A total of 730 adolescents were surveyed, 363 completing the questionnaire on unwanted pregnancy and 367 completing the one on STBBIs. To identify the determinants of adolescents' intention to seek online information on unwanted pregnancies and STBBIs, several multivariate logistic analysis models were estimated, stratifying by sex and by the SRH issue (unwanted pregnancies and STBBIs). The results from these estimations suggest that the determinants of the intention to seek SRH information online differ by sex and by SRH issue. Regarding the intention to seek information on unwanted pregnancies online, the explained variance of the final model is 38% for boys and 37.90% for girls. For boys, the main determinants of intention to seek information about unwanted pregnancies online are cognitive attitude (OR = 4.6; CI95%: 1.70 - 12.21), past behaviour (OR = 5.5; CI95%: 1.93 - 15.85) and subjective norm (OR = 3.2; CI95%: 1.34 - 7.43). For girls, cognitive attitude (OR = 23.3; 95% CI: 2.40 - 32.68) appears to be the main determinant of intention. Regarding the intention to seek information on STBBIs online, the explained variance of the final model is 40.17% for boys and 33.28% for girls. For boys, the main determinants of the intention to seek information on STBBIs online were cognitive attitude (OR = 6.8; CI95%: 2.13 - 21.46), affective attitude (OR = 3.6; CI95%: 1.42 - 9.14) and past behaviour (OR = 3.3; CI95%: 1.19 - 9.10). For girls, only statistical relationships were observed in the predictive models of intention to seek information about STBBIs online. In light of these results, communication strategies in Burkina Faso aiming to enhance adolescents' online information seeking about SRH should be adjusted to incorporate these determinants. While the results of this thesis support possible actions in health communication, improving adolescent SRH in Burkina Faso will require a more comprehensive and global public health approac

Is there an early gender gap in Ghanaian children development? Evidence from 3-4 years old boys and girls

Using data from the 2011 round of the Ghana Multiple Indicator Cluster Survey (MICS), we investigate the presence of an early gender gap in child development among children 3-4-year-old. Based on that survey, we built multidimensional indexes of child development that account for children’s ability to read, count, recognize numbers, interact with peers and others, follow rules and be independent for their health outcomes and for their physical skills. This allowed us to estimate the gender gap while controlling for factors affecting child development. Using this approach, we found overall no evidence of gender difference in children’s child development. One index suggests that being female is associated with higher children development. This result is robust to several specifications and sensitivity tests. We also found that a mother’s education, a father’s involvement and the fact of living in an urban area, all increase child development both for boys and for girls. In terms of policy, these findings indicate that the educational gender gap in Ghana most likely reflects unequal access to schooling opportunities between boys and girls

Early Childhood Education and Children Development : Evidence from Ghana

While early childhood education (ECE) has received rising interest from researchers in recent years, its effect on child development is still unclear in Sub-Saharan Africa. This paper investigates the effectiveness of ECE on 3-4 years old children development outcomes in Ghana. We exploit data from the 2011 round of the Ghana Multiple Indicator Cluster Survey (MICS), to build a multidimensional early child development index that accounts for children’s ability to read, count, recognize number, interact with peers and other people, follow rules and be independent as well as their health outcomes and physical skills. Then, we estimate the effect of ECE on child development using an endogenous treatment effect model to account for children unequal access to ECE. Results indicate that attending to ECE program increases children early development indicator. This finding is robust to several changes in the specifications

Is there an early gender gap in Ghanaian children development? Evidence from 3-4 years old boys and girls

Using data from the 2011 round of the Ghana Multiple Indicator Cluster Survey (MICS), we investigate the presence of an early gender gap in child development among children 3-4-year-old. Based on that survey, we built multidimensional indexes of child development that account for children’s ability to read, count, recognize numbers, interact with peers and others, follow rules and be independent for their health outcomes and for their physical skills. This allowed us to estimate the gender gap while controlling for factors affecting child development. Using this approach, we found overall no evidence of gender difference in children’s child development. One index suggests that being female is associated with higher children development. This result is robust to several specifications and sensitivity tests. We also found that a mother’s education, a father’s involvement and the fact of living in an urban area, all increase child development both for boys and for girls. In terms of policy, these findings indicate that the educational gender gap in Ghana most likely reflects unequal access to schooling opportunities between boys and girls

How Does Exposure to Mass Media affect HIV Testing and HIV-Related Knowledge Among Adolescents? Evidence From Uganda

Sexual and reproductive health remains one of the greatest challenges in developing countries. In Uganda, adolescents are the most vulnerable group as far as HIV epidemic is concerned. Mass media awareness campaigns play a key role in promoting sexual and reproductive health among adolescents. Using Uganda’s 2016 Demographic Health Survey, we examine the causal effect of mass media exposure on the probability of adolescents getting an HIV test and their HIV-related knowledge. Our results suggest that the exposure to mass media increases both adolescents’ likelihood to get tested for HIV and their HIV-related knowledge score. In fact, we find that reading newspapers once a week increases the likelihood of an adolescent to test for HIV by 6.29 percentage points. Listening to radio once a week increases the probability to test for HIV by 4.57 percentage points. This effect increases to 6.56 percentage points when the adolescent listens to the radio more than once a week. Watching TV more than once a week increases adolescents’ probability to get tested for HIV by 8.57 percentage points. For HIV-related knowledge, we find that compared to adolescents who do not read newspapers at all, adolescents who read newspapers less than once a week and those who read newspapers at least once a week have a higher score of HIV-related knowledge of 9.12% and 9.64% respectively. Compared to adolescents who do not listen to radio at all, adolescents who listen to radio less than once a week have a higher (5.88%) score of HIV related knowledge. Moreover, listening to radio at least once a week increases the score of HIV-related knowledge by 5.52%. Hence, mass media awareness campaigns are important policies to promote HIV testing and HIV-related knowledge among adolescents in Uganda