Trends and predictors of home deliveries in Kassena-Nankana East and West districts in Ghana: 2003-2009

Introduction: About sixty million of home deliveries occur worldwide every year. The vast majority of them in Low and Middle Income Countries (LMIC) where most of all out of health facility deliveries are attended by relatives and traditional births attendants . Poor hygienic conditions, ignorance of clean birth practices and lack of skills to manage the complications when they occur, make home deliveries unsafe for the mothers and their new-borns. Thus, getting pregnant women to give birth at health facility is critical in the efforts to improve reproductive health outcomes in many LMIC

Exposure to conditions of high concentrations of indoor air pollutants and prevalence of ARIs in children under 5 years of age, in Ouagadougou/Burkina Faso

The objective was to highlight effects of exposure to high concentrations of PM2.5 (emitted during cooking) on the prevalence of acute respiratory infections (ARI) in children under 5 years of age. Results showed that the use of biomass in indoor kitchens in residential buildings in Uganda was linked to the occurrence of ARI in children. Living in a house with several bedrooms was a protective factor. Fine particulate matter (PM2.5) is an air pollutant which can affect people's health when levels are high

CONTENT ADHERENCE TO FIDELITY

Content adherence of seasonal malaria chemoprevention intervention's activities to implementation fidelity in Kaya health district in 2014 and 201

SCHEDULE ADHERENCE TO IMPLEMENTATION FIDELITY

Schedule adherence of seasonal malaria chemoprevention intervention's activities to implementation fidelity in Kaya health district in 2014 and 201

Prevalence and factors associated with hypertension in Burkina Faso: a countrywide cross-sectional study

Abstract Background High blood pressure (HBP) is an increasing public health issue for developing countries. HBP is an important contributing factor to many non-communicable diseases that were until very recently thought to be rare in developing countries. There is not enough evidence on its burden and risk factors in Africa. We report in this study on the prevalence and factors associated with HBP in the adult and active population of Burkina Faso from a nationally representative sample. Methods We conducted a secondary analysis of data from the World Health Organization (WHO) Stepwise approach to Surveillance(STEPS) survey on the prevalence of major risk factors for non-communicable diseases in Burkina Faso. This survey was conducted between September 26 and November 18, 2013 and involved a nationally representative sample of 4,800 adults aged 25 to 64\ua0years. The risk factors were identified using a binary logistic regression in STATA Version 13.1 software. Results The analysis was conducted on a sample of 4629 participants of whom 72.18% lived in rural areas. The overall prevalence of hypertension in Burkina Faso was 18% (95% CI: 16.19%\u201319.96%). In urban areas the prevalence was 24.81% (95% CI 20.21%\u201330.07%) and 15.37% (95% CI 13.67%\u201317.24%) in rural areas. Increased Body Mass Index (BMI) and older age were consistently associated with higher odds of HBP in both residential areas. In addition, being of male sex, fat intake, family history of HBP and low level of HDL cholesterol were significantly associated with increased odds of HBP in rural residents. Conclusion The prevalence of hypertension is high in Burkina Faso with roughly one person in five affected. There is a predominant burden in urban areas with prevalence of ten-point percent higher compared to rural area. Modifiable risk factors should be targeted with appropriate and effective strategies to curb the rising burden of hypertension and its consequences

L'Auto-vélo : automobilisme, cyclisme, athlétisme, yachting, aérostation, escrime, hippisme / dir. Henri Desgranges

07 juin 19331933/06/07 (A34,N11862)

Prevalence and risk factors for overweight and obesity: a cross-sectional countrywide study in Burkina Faso

Objective The objective of this study was to determine the prevalence and predictors of overweight and obesity in Burkina Faso using a population-based countrywide sample. We hypothesise that there is a significant burden related to overweight/obesity in Burkina Faso.Design Secondary analysis of a population-based countrywide cross-sectional study.Setting Burkina Faso, all the 13 regions including both rural and urban residential areas.Participants 4800 participants of both sexes, aged between 25 and 64 years.Main outcomes Overweight and obesity using body mass index cut-off levels of the WHO.Results The prevalence of overweight and obesity in Burkina Faso were 13.82% (95% CI: 12.25 to 15.55) and 4.84% (95% CI: 3.99 to 5.86), respectively. Among men, the proportional odds of overweight/obesity increase with urban residency (p<0.001), greater age (p<0.002), marital status different from single (p≤0.007) and decrease with current smoking (p=0.009). Among women, the proportional odds of overweight/obesity increase with urban residency (p<0.001), primary educational level (p=0.01), high total blood cholesterol level (p<0.001) and high fasting blood glucose level (p=0.02), and decrease with current smoking (p<0.001).Conclusion Our study showed that nearly one person out of five in the adult population of Burkina has an abnormal weight status with women being more affected than men. Urban residency is a consistent risk factor in both men and women. Alcohol consumption and education were associated with an increased odds in only women. Overnutrition needs to be recognised as an important public health issue in Burkina Faso and nutrition interventions need to be reshaped to account for it

Abolishing Fees at Health Centers in the Context of Community Case Management of Malaria: What Effects on Treatment-Seeking Practices for Febrile Children in Rural Burkina Faso?

Burkina Faso started nationwide community case management of malaria (CCMm) in 2010. In 2011, health center user fees for children under five were abolished in some districts.To assess the effects of concurrent implementation of CCMm and user fees abolition on treatment-seeking practices for febrile children.This is a natural experiment conducted in the districts of Kaya (CCMm plus user fees abolition) and Zorgho (CCMm only). Registry data from 2005 to 2014 on visits for malaria were collected from all eight rural health centers in the study area. Annual household surveys were administered during malaria transmission season in 2011 and 2012 in 1,035 randomly selected rural households. Interrupted time series models were fitted for registry data and Fine and Gray's competing risks models for survey data.User fees abolition in Kaya significantly increased health center use by eligible children with malaria (incidence rate ratio for intercept change = 2.1, p <0.001). In 2011, in Kaya, likelihood of health center use for febrile children was three times higher and CHW use three times lower when caregivers knew services were free. Among the 421 children with fever in 2012, the delay before visiting a health center was significantly shorter in Kaya than in Zorgho (1.46 versus 1.79 days, p <0.05). Likelihood of visiting a health center on the first day of fever among households <2.5 km or <5 km from a health center was two and three times higher in Kaya than in Zorgho, respectively (p <0.001).User fees abolition reduced visit delay for febrile children living close to health centers. It also increased demand for and use of health center for children with malaria. Concurrently, demand for CHWs' services diminished. User fees abolition and CCMm should be coordinated to maximize prompt access to treatment in rural areas

Inadequate programming, insufficient communication and non-compliance with the basic principles of maternal death audits in health districts in Burkina Faso: a qualitative study

Abstract Background Implementation of quality maternal death audits requires good programming, good communication and compliance with core principles. Studies on compliance with core principles in the conduct of maternal death audits (MDAs) exist but were conducted in urban areas, at the 2nd or 3rd level of the healthcare system, in experimental situations, or in a context of skills-building projects or technical platforms with an emphasis on the review of “near miss”. This study aims to fill the gap of evidence on the implementation of MDAs in rural settings, at the first level of care and in the routine care situation in Burkina Faso. Methods We conducted a multiple-case study, with seven cases (health districts) chosen by contrasted purposive sampling using four criteria: (i) the intra-hospital maternal mortality rates for 2013, (ii) rural versus urban location, (iii) proofs of regular conduct of maternal death audits (MDAs) as per routine health information system, and (iv) the use of district hospital versus regional hospital for reference when the first mentioned does not exist. A review of audit records and structured and semi-structured interviews with staff involved in MDAs were conducted. The survey was conducted from 27 April to 30 May of 2015. Results The results showed that maternal death audits (MDAs) were irregularly scheduled, mostly driven by critical events. Overall, preparing sessions, communication and the conduct of MDAs were most of the time inadequate. Confidentiality was globally respected during the clinical audit sessions. The principle of “no name, no shame, and no blame” was differently applied and anonymity was rarely preserved. Conclusion Programming, communication, and compliance with the basic principles in the conduct of maternal death audits were inadequate as compared to the national standards. Identifying determinants of such shortcomings may help guide interventions to improve the quality of clinical audits. Resume La mise en œuvre d’audits de décès maternels de qualité nécessite une bonne programmation, une bonne communication et le respect des principes fondamentaux. Des études sur le respect des principes fondamentaux existent mais ont été menées dans les zones urbaines, le 2ème ou 3ème niveau du système de santé, dans des situations expérimentales, un contexte de projets de renforcement des compétences ou de plates-formes techniques, en mettant l’accent sur la revue des «near miss». Cette étude vise à combler le manque d’information sur la programmation et le respect des principes fondamentaux concernant le milieu rural, le niveau du système de santé qui est. le district sanitaire et la situation de routine au Burkina Faso. Méthodologie Nous avons mené une étude de cas multiple dans 7 établissements de santé sélectionnés par échantillonnage raisonné contrasté selon 4 critères: milieu urbain ou rural, taux de mortalité maternelle dans les établissements de santé en 2013 (les données de l’année 2014 n’étant pas complètes à la rédaction du protocole), la déclaration des audits de décès maternels dans le système de surveillance nationale, le recours ou non par le district choisi à un centre hospitalier régional pour les soins complémentaires de premier niveau (normalement offerts à l’hôpital de district s’il existe). Une revue des dossiers d’audits, ainsi que des entretiens directifs, semi-directifs auprès du personnel impliqué dans les soins de maternité ont été réalisés. L’enquête s’est. déroulée du 27 Avril au 30 Mai 2015. Résultats Les résultats montrent que les revues des décès maternels ont été irrégulièrement programmées, de façon espacée et très souvent au gré des évènements. La préparation, la conduite des séances et la communication après les séances ont été défaillantes. La confidentialité au sein du groupe d’auditeurs a été respectée tandis que le niveau de respect du principe de « no name, no shame, no blame » a varié d’une structure à une autre. Enfin, l’anonymat a été le moins respecté. Conclusion La programmation, la communication et le respect des principes fondamentaux ont connu des défaillances par rapport aux normes mais de façon variable d’une structure à une autre. L’identification des déterminants de ces insuffisances pourront aider à l’orientation des interventions visant l’amélioration de l’activité des audits de décès maternels au niveau district de santé

Content fidelity of the SMC components in 2014 and 2015.

<p>Notes: I = implemented as intended; I/M = implemented or modified; M = modified; N = not implemented.</p