Non-Communicable Disease Mortality and Risk Factors in Formal and Informal Neighborhoods, Ouagadougou, Burkina Faso: Evidence from a Health and Demographic Surveillance System

The expected growth in NCDs in cities is one of the most important health challenges of the coming decades in Sub-Saharan countries. This paper aims to fill the gap in our understanding of socio-economic differentials in NCD mortality and risk in low and middle income neighborhoods in urban Africa. We use data collected in the Ouagadougou Health and Demographic Surveillance System. 409 deaths were recorded between 2009–2011 among 20,836 individuals aged 35 years and older; verbal autopsies and the InterVA program were used to determine the probable cause of death. A random survey asked in 2011 1,039 adults aged 35 and over about tobacco use, heavy alcohol consumption, lack of physical activity and measured their weight, height, and blood pressure. These data reveal a high level of premature mortality due to NCDs in all neighborhoods: NCD mortality increases substantially by age 50. NCD mortality is greater in formal neighborhoods, while adult communicable disease mortality remains high, especially in informal neighborhoods. There is a high prevalence of risk factors for NCDs in the studied neighborhoods, with over one-fourth of the adults being overweight and over one-fourth having hypertension. Better-off residents are more prone to physical inactivity and excessive weight, while vulnerable populations such as widows/divorced individuals and migrants suffer more from higher blood pressure. Females have a significantly lower risk of being smokers or heavy drinkers, while they are more likely to be physically inactive or overweight, especially when married. Muslim individuals are less likely to be smokers or heavy drinkers, but have a higher blood pressure. Everything else being constant, individuals living in formal neighborhoods are more often overweight. The data presented make clear the pressing need to develop effective programs to reduce NCD risk across all types of neighborhoods in African cities, and suggest several entry points for community-based prevention programs

Dataset for "Involving male partners in maternity care in Burkina Faso: a randomized controlled trial"

Dataset and supplementary material collected as part of a public health intervention study. The study sought to determine whether an intervention to involve male partners in maternity care of pregnant women influenced care-seeking, healthy breastfeeding and contraceptive practices after childbirth. The dataset includes baseline socio-demographic data on study participants, information about treatment arm assignment and adherence to the intervention, and health and behaviour outcomes in the postpartum period. It brings together data from four collection points: [1] the baseline interview, [2] the 3-month postpartum follow-up interview, [3] the 8-month postpartum follow-up interview, and [4] process data on attendance at the three intervention sessions. Also included are the informed consent form, the information sheet, and the three questionnaires for the baseline interview, 3-month and 8-month postpartum follow-up interviews

WHO Multi-Country Survey on Abortion-related Morbidity and Mortality in Health Facilities: study protocol

Introduction: According to the WHO, abortion accounts for about 8% (4.7–13.2) of maternal mortality worldwide. In 2010, the WHO Multi-Country Survey (MCS) on Maternal and Newborn Health collected data on over 300 000 women who were admitted in health facilities to receive pregnancy-related care. Abortion data were partially captured by centring on severe maternal outcomes (ie, near-miss or maternal deaths). Building on the experiences of the prior MCS as well as current WHO reproductive health projects, we are undertaking a multi-country survey to better capture the burden and severity of abortion-related complications and management among women presenting to the health facilities. Methods and analysis: This is a large cross-sectional study with prospective data collection. It will be implemented in health facilities in 30 countries across the WHO regions of Africa, Americas, Eastern Mediterranean, Europe, South East Asia and Western Pacific. Countries and facilities will be identified through a multistage sampling methodology. Data collection will be at both the facility and individual levels, involving review of medical records and exit surveys with eligible women using audio computer-assisted self-interview. All women presenting to the health facilities with signs and symptoms of abortion complications will comprise the study population. Online data entry and management will be performed on a web-based data management system. Analysis will include prevalence of abortion-related complications and descriptive frequencies of procedural/non-procedural management and experience of care. Ethics and dissemination: Ethical issues of the consent process are addressed. Dissemination plans will involve the participating facilities and communities to further strengthen abortion-related research capacity within the MCS on Abortion (MCS-A) countries. Furthermore, dissemination of results will be an iterative process at both the facility and national level to potentially propagate positive changes to abortion-related policies and practices

Developing a forward-looking agenda and methodologies for research of self-use of medical abortion

Research has not kept abreast of women’s self-use of medical abortion, leaving many gaps in the scientific literature regarding the ideal conditions for safe and effective use. Therefore, our main objectives were to assess the research gaps highlighted during the conference, identify specific challenges to conducting research on medical abortion self-use, and to share promising research methodologies to advance this research. Although there are overlaps with the recommended and wellresearched practice of women’s self-management of the abortion process at home after receiving medical abortion medicines, screening and information from a clinician [1], our intent was focused on the emerging practice of self-use

Qualitative research in demography: quality, presentation and assessment

Social scientists need to identify, assess, aggregate, interpret and disseminate the highest quality evidence, whilst acknowledging that quality is an abstract concept. Despite peer review, recent use of qualitative approaches within demographic research has not always been accompanied by critical assessment of the quality of qualitative data and analyses. This contrasts with the sophisticated tools for assessing quantitative demographic data quality. Three objectives are addressed. Firstly, to review approaches to the assessment of the quality of published qualitative research from other disciplines, and how these advances might be used and adapted by demography. Secondly, using illustrations from our own work we discuss various dimensions of the use and presentation of qualitative demographic research and the different steps which should be taken in terms of documention, reflection and presentation to facilitate assessment of quality. Finally, in an update of Randall & Koppenhaver (2004), we describe the diffusion of qualitative approaches, to identify diverse elements which should allow the reader to judge of the validity of demographic results presented

L'avortement : un secret connu de tous ?

L'objectif de cette analyse est de montrer que la pratique de l'avortement clandestin au Burkina Faso est régie par les mécanismes du secret. En utilisant des données collectées en 2000 en milieu rural (n=13) et en milieu urbain et peri-urbain en 2001 (n=30), nous retraçons le processus d'avortement au Burkina Faso depuis la prise de décision jusqu'aux complications. Comme c'est le cas pour tous les secrets, l'information sur l'avortement circule dans un segment délimité du réseau social des femmes : elles sollicitent d'abord leur paires, parfois leurs parentes proches. Nous mettons à jour les systèmes de sécurité mis en place pour protéger le secret de l'avortement (relations de confidence ou transgression partagée), ainsi que les forces qui tendent à le rompre (fuites, espionnage et commérage). Comprendre la pratique de l'avortement comme un cas particulier des théories sociologiques du secret permet de faire un certain nombre d'hypothèses. Tout secret étant le produit de tensions entre des références normatives divergentes, on peut penser que la hausse actuelle du recours à l'avortement observée en Afrique de l'Ouest urbaine résulte d'un rapide et conflictuel changement dans les normes sexuelles et reproductives. On peut comprendre aussi la sous-déclaration des avortements (légaux) dans les enquêtes comme une stratégie (le secret) de gestion d'une pratique qui reste stigmatisée

Abortion: An Open Secret? Abortion and Social Network Involvement in Burkina Faso

Abortion in Burkina Faso is a subject that neither abortion providers nor women want to talk about. Abortion providers fear criminal prosecution; women's silence is dictated more by the wish to avoid the stigma of a ‘‘shameful'' pregnancy. Qualitative investigations in Burkina Faso among 13 key informants in a rural village in 2000 and 30 women and men aware of experience of abortion in the capital Ouagadougou in 2001, explored two paradoxes: what prompts women and providers to reveal something they want to be kept totally secret, and how do women keep their abortion secret while nevertheless talking to others about it? The study found that young women in Burkina Faso are impelled to talk to their boyfriends, friends and in fewer cases women relatives about their unplanned pregnancy, first to decide to have an abortion and then to get help in finding a clandestine provider. Abortion is also kept secret because it is a subject on which there is no social consensus, alongside extra-marital sexual activity, contraceptive use by young people and out-of-wedlock pregnancies. The key to keeping a secret lies in the choice of those with whom to share it; good confidants are those who are bound by secrecy through the bonds of intimacy or shared transgression

Augmentation de l'avortement et baisse de la fécondité en Afrique de l'Ouest urbaine

Dans le sixième chapitre de l'ouvrage, Clémentine Rossier pose la question du recours croissant à l'avortement dans les premières phases des transitions de la fécondité en Afrique. En effet, si les besoins de maîtrise de la fécondité augmentent avec la volonté de limiter la descendance, il est nécessaire de se demander pourquoi d'autres mode de régulation des naissances (abstinence, contraception moderne ou naturelle) ne sont pas choisis en priorité. Dans son analyse, elle discute des évolutions dans les choix des femmes entre ces trois modes de régulations des naissances possibles, en s'attachant tout particulièrement à l'évolution des pratiques d'abstinence prémaritale et post-partum, en rapport avec l'évolution actuelle des comportements matrimoniaux

Le nombre d'avortements provoqués augmente quand on libéralise cette pratique

Dans les pays où cette pratique n'est pas encore libéralisée, on craint souvent qu'une relaxation de la loi entraîne la multiplication du recours à l'avortement. Or, tant l'expérience des pays qui ont libéralisé leur loi que l'examen des statistiques mondiales d'avortement montrent un effet contraire à long terme. Les régions du monde caractérisées par une part plus grande de femmes qui vivent dans des pays où l'avortement provoqué est illégal sont également les régions où la fréquence de cette pratique est la plus grande. Le désir d'éviter une naissance et l'utilisation de la contraception expliquent le niveau du recours à l'avortement dans un pays, bien plus que sa loi sur l'avortement. Parce que ces deux facteurs augmentent avec le niveau de développement d'un pays, et parce qu'ils ont un effet opposé sur le recours à l'avortement, une augmentation précède souvent son déclin. La libéralisation de l'avortement peut intervenir à n'importe quel moment de ce processus historique