Maternal Health in Urban Areas: Therapeutic Use and Barriers Identified by Pregnant Women, Parturients, and New Mothers in the Commune of Koumassi in Abidjan

The supply of care is diverse and varied in urban areas. This may influence women’s use of health care. The goal of this study is to investigate the therapeutic use of pregnant women, parturients, and new mothers and the barriers revealed by the latter in the commune of Koumassi in Abidjan. The data for this study come from the 2020 database of the Groupe de recherche espace territoire, société et santé (GRETSSA) of the Institut de Géographie Tropicale (IGT). Indeed, GRETSSA conducted a large cross-sectional survey in the 10 communes of the city of Abidjan among 3600 households. There were 102 parturients, new mothers, and pregnant women identified in the sample for the commune of Koumassi. Based on descriptive statistical analysis, the results of this study show that women go more to a modern health service at the beginning of their pregnancies (69%). This tendency, paradoxically, decreases as the pregnancy progresses and is again high when women are at term (70.2%). On average, mothers-to-be have made a total of 3.3 prenatal visits (PNC) to the maternity hospital regularly. This represents at least one PNC per pregnant woman. Our study identified barriers to seeking care. Among these barriers, the lack of quality of care and the still-high costs of some health services affect the demand for maternal care

Linking Social Capital to Therapeutic Practices in Korhogo, Côte d’Ivoire

In the northern areas of Côte d’Ivoire most affected by the 2010/2011 post-electoral armed conflict, the functioning and use of health services were negatively influenced. This study seeks to describe the nature of the social capital of Korhogo households and to analyze its influence on their choices in terms of therapeutic practices. The study, both quantitative and qualitative, was carried out in the North of the country, more precisely in Korhogo, a city located in the Poro region. The questionnaire was administered to 588 heads of households in 49 enumeration areas. In these EAs, 38 semi-structured interviews and 6 focus groups were also organized with health workers, traditional healers and local leaders. Overall, households perceive two forms of social capital: individual social capital and collective social capital. On the basis of this more or less clear knowledge of social capital, almost all households (92.8%) say they rely on the “human resources” dimensions compared to just over two-thirds (69.2%) for those relating to financial resources. Modern medicine (36.1%) and traditional medicine (32.8%) are the most dominant in the region. The majority of households (83.0%) are led to opt for a therapeutic practice following discussions with the members of their networks. However, the human, material and financial dimensions of social capital have little influence on the choice of therapeutic practices for households. All initiatives aimed at strengthening solidarity are likely to contribute to promoting the health and well-being of disadvantaged households in situations of socio-political crises

Access and appeal in the care of modern health in urban zones : the case of the city of Abidjan - Ivory coast

La ville d’Abidjan est localisée au Sud de la Côte d’Ivoire. Elle est la capitale économique depuis 1983 et la première ville du pays. Elle concentre le potentiel humain et une offre de soins dense et diversifiée répartie sur de faibles distances physiques, donnant l’impression que tout est accessible. En effet, l’État Ivoirien a consenti d’importants investissements pour construire et équiper des services de santé depuis l’émergence de la ville au début du siècle dernier pour améliorer l’accès aux soins des abidjanais. Pourtant, malgré une augmentation considérable du nombre d’infrastructures sanitaires et de leur disponibilité, les taux d’utilisations et de fréquentations des services de santé modernes dans les communes de la ville d’Abidjan restent faibles et les indicateurs de santé demeurent très préoccupants et les besoins de soins sont importants. En plus, la croissance spatiale et démographique accélérée que connaît la ville entraînent des changements rapides dans son organisation territoriale empêchant les autorités publiques chargées de la planification de suivre le rythme de sa croissance urbaine. Ils ne sont pas toujours parvenus à équiper en services urbains les nouveaux espaces au fur et à mesure de leur création et à intégrer les nouveaux citadins aux origines diverses. Cette thèse permet d’étudier, comment, dans un contexte considéré comme privilégié, se pose la problématique de l’accès et du recours aux services de santé modernes. Pour réaliser ce projet, cette étude, à partir des combinaisons d’analyses spatiales, statistiques, et d’un travail de terrain, analyse les inégalités socio-spatiales d’accès aux services de santé pour mettre en exergue le problème de l’accessibilité aux soins, tant physique, culturelle, matérielle que sociale. Elle mesure également l’adéquation de cette offre de soins moderne aux besoins de soins des populations pour identifier les zones et les populations défavorisées pour l’accès aux soins. Et enfin, cette étude analyse les pratiques citadines du recours aux soins, ainsi que les déterminants qui limitent ou facilitent l’accès aux soins dans la ville d’Abidjan. Les résultats des études montrent que les services de santé existent, ils sont denses et diversifiés, mais ils ne sont pas repartis là où il y a le plus de besoins de soins. Dans notre étude, on souligne aussi une prédominance de la prise en charge à domicile des épisodes morbides notamment à travers l’automédication et une diminution de l’utilisation des services de soins modernes. Le recours aux structures de soins se fait rare dans les quartiers où les besoins en soins de santé sont les plus importants. L’automédication ou la médecine de rue sont généralement les plus privilégiées. Les structures de soins sont sollicitées que lorsque la maladie devient très grave. Nos résultats montrent également qu’il est difficile d’attribuer à un facteur le rôle déterminant des recours thérapeutiques, car les comportements sont à la fois déterminés par les caractéristiques socio-démographiques de l’individu, de sa famille et par des paramètres contextuels, mais aussi par les caractéristiques de l’épisode morbide, par la connaissance du système de soins environnant et les attitudes vis-à-vis du système de soins. Néanmoins, nous pouvons dire qu’à Abidjan, les pratiques citadines du recours aux soins sont tributaires de la capacité économique des ménages avec le risque accru de marginaliser les personnes les plus vulnérables.The city of Abidjan is located in the South of the Ivory Coast. It is the economic capital since 1983 and the first city of the country. It concentrates human potential and health of dense care supply modern and diversified divided on weak physical distance, giving the impression that everything is approachable. In effect, the State Of the Ivory Coast approved important investments to construct and equip services of health care since the emergence of the city at the beginning of last century to ameliorate the access to health care of abidjanais. However, in spite of a considerable increase among health facilities and among their availability, the rates of uses and company of the services of modern health care in the spaces of the city of Abidjan remain weak and the indicators of health remain very worrying and the needs in care of health are important. On top of that, the space and demographic speeded up growth which knows the city draw away quick changes in her territorial organization preventing the public authorities made responsible with planning for following the rhythm of its urban growth. They did not always manage to equip new urban spaces with timely urban services and to integrate new citizens at the various origins. This thesis allows to be studying, how, in a considered context as privileged, settle the problems of access and health care seeking in the services of modern health. To accomplish this plan, this study, from the combination of spatial analysis, statistics, and field work, analyses the socio- spatial inequality of access to the services of health to head with the problem of accessibility in care, so physical, cultural, material that social. It also measures the adequacy of health care supply at the Needs in care of health of populations to identify zones and populations discriminated for the access to health care. And finally, this study analyses the city practices in the use of health care, as well as the determinants that hinder or facilitate access to health care in the city of Abidjan. Study results show that the services of health exist, they are dense and manifold, but they did not leave again where there are most needs in care of health. In our study, they also underline a predominance of the taking care at home of morbid episodes notably across self-medication and a reduction of the use of the services of modern care. The seeking in structures of health care becomes rare in the space where the needs in care of health are the most important. Self-medication or street medicine are the most favouring in general. Structures of health care are solicited that when illness becomes very serious. Our results also show that it is difficult to allocate to a factor the role determining therapeutic seeking, because behaviours are determined at the same time by the socio-demographic characteristics of the individual, his family and by contextual parameters, but also by the characteristics of morbid episode, by the knowledge of the ambient the health care system and attitudes in relation to the health care system. However, we can say that in Abidjan, the city practices of health care seeking are dependent on the economic capacity of household with risk augmented to marginalize the most vulnerable persons

Analyse de l’adéquation entre offre de soins primaires et besoins de soins à Abidjan, (Côte d’Ivoire)

International audienceThe goal of this study is to analyze the adequacy of primary health care supply and people’s health care needs in Abidjan. A modeling of social and demographic indicators (age, level of life, morbidity, etc.) was used to determine the predictable levels of health care consumption related to potential health care needs in social spaces. Thereafter, a Geographic Information System (GIS) was created to spatialize the findings of the statistical analysis in conjunction with health indicators.The study found strong spatial disparities in health coverage. We noticed a low spatial association between access to health care supply and the level of health care needs, which opposes the west and the north of the city. In there, we notice a double handicap related to the low level of accessibility and high-level health care needs and east socially rich and benefiting a strong accessibility and a need to lower health care. However, this opposition must be nuance, since we notified the low accessibility regions in the east and areas of high accessibility to the center and southeast. That expresses firstly, the problems in the spatial allocation of the health care supply and population growth of the city of Abidjan, and secondly, the inadequacy of health care needs and, primary health care supply.L’objectif de cette étude est d’analyser l’adéquation entre l’offre de soins primaires et les besoins de soins des populations dans la ville d’Abidjan. Une modélisation d’indicateurs sociaux et démographiques a été utilisée pour déterminer les niveaux prévisibles de consommation de soins relatifs aux besoins de soins potentiels dans les espaces sociaux. Par la suite, un Système d’Information Géographique (SIG) a été mis en place pourspatialiser les résultats de l’analyse statistique conjointement avec les indicateurs de santé. L’étude a révélé de fortes disparités spatiales de couverture sanitaire. On note une association spatiale faible entre l’accessibilité à l’offre de soinset le niveau de besoins aux soins, opposant l’ouest et le nord de la ville. Un faible niveau d’accessibilité et un fort niveau de besoins de soins au nord est relevé. Par contre, l’est d’Abidjan, socialement plus aisé, bénéficie d’une forte accessibilité et d’un besoin de soins plus faible. Néanmoins, cette opposition est à nuancer, puisqu’on observe des zones de faibles accessibilités à l’est et des zones de fortes accessibilités au centre et au sud-est. Cela exprime d’une part, le problème dans la distribution spatiale de l’offre de soins et de l’accroissement démographique de la ville d’Abidjan et d’autre part, l’inadéquation entre besoins de soins et offre de soins primaires

Croissance urbaine et mobilité quotidienne de la population: l'intérêt du troisième pont de la ville d'Abidjan (Côte d'Ivoire)

International audienc

Prise en charge des enfants victimes de troubles mentaux dans le District sanitaire de Ferkessédougou (Côte d’Ivoire): offre de soins etitinéraires thérapeutiques

International audienc

Gestion des déchets liquides et vulnérabilité des populations aux maladies: Cas de Songon-Agban, District d'Abidjan

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Gestion des déchets liquides et vulnérabilité des populations aux maladies: cas de Songon-Agban, district d'Abidjan

Management of Waste liquids and Vulnerability of the Population to Diseases: Case of Songon-Agban District of Abidjan. In Songo-Agban, district of Abidjan, the spatial and demographic dynamic goes together with a lack of urban waste management services. This phenomenon causes the proliferation of waste liquids and exposes resident populations to environmental diseases. Faced with an uncontrolled population growth and the urgent lack of sanitation infrastructures, sewage management and its impact on the population is becoming worrying. The objective of this study is to analyze the practices of the population concerning the management of waste liquids , their impact on the environment and the vulnerability of the populations to environmental diseases. Analysis of primary and secondary data collected reveals an individual and inefficient management of waste liquids in Songon-Agban. The households drain sewage in septic tanks, cesspools and even in the street. These different practices damage the living environment and expose the population to environmental diseases, in particular malaria, typhoid fever, diarrheal diseases and acute respiratory infections