Obstetric emergencies in a humanitarian context at the Somine Dolo hospital in Mopti, Mali

Background: Conflicts are a barrier to physical and financial access to health centers. Our objective was to evaluate obstetric emergencies in a humanitarian context at the Sominé DOLO hospital in Mopti.Methods: This was a descriptive and prospective longitudinal study from January to September, 2020 in the obstetrical gynecology department of the Sominé DOLO hospital in Mopti. Our objective was to evaluate obstetric emergencies in the humanitarian context.Results: The frequency of patients evacuated was 30.61%. The average age of the patients was 27 years with extremes of 15 and 49 years. Hemorrhage during pregnancy was the main cause of reference with 23.83%. The ambulance was the most used means of transport with 51%. Delay in evacuation was observed in 31.33 cases. About 73.03% of our patients had given birth by caesarean section. We recorded 64 maternal deaths, a rate of 10.67%. Fetal mortality in our study was 23.28%. Attacks by armed groups had a negative impact on the referral/evacuation system.Conclusions: The health system had experienced severe challenges due to insecurity. Armed conflicts were the cause of evacuation delays. Haemorrhage during pregnancy was the main reference cause. Maternal and perinatal mortality was high

Conclusions of ten years of maternal death surveillance and response in the health district of commune V of Bamako, Mali

Background: The purpose of this study was to report the findings of the local maternal deaths surveillance and response (MDSR) committee in the health district of Municipality V of the district of Bamako. Methods: It was a retrospective study over a period from January 2009 to December 2017. We have compiled all the findings of the local MDSR committee from the health district of Municipality V. The data was generated from the Local Health Information System (LHIS). We made a simple entry of text and tables using Word and Excel software. Results: During the study period, the maternal mortality ratio (MMR) was 219/100,000 live births. The study was about 140 cases of maternal deaths that occurred in health facilities. The middle age of the patients was 28.01 years. Most of the deaths occurred in the postpartum period, with 106 cases. In 92.12%, the deaths were from direct obstetric causes (DOC), including hemorrhage 70%, eclampsia 7.85%, obstructed labor 7.14%. Seven deaths (5%) were from indirect obstetric causes (IOC), including anemia 3.57% and malaria 1.73%. In 2.58%, the deaths were from undetermined causes. Deaths were preventable in 80%. The response included, among other things, the notification of cases and the implementation of the recommendations made. In 70% of cases, the recommendations issued were implemented. Conclusions:  The MMR remains high in Municipality V of the district of Bamako. These deaths were mostly from DOCs, with hemorrhage as the main cause. These deaths were mostly preventable.

Ownership Structure and Bank Efficiency in Six Asian Countries

International audienceThis paper focuses on efficiency measures of banks from six countries in Southeast and East Asia. We use a two-stage approach to study the post-crisis period 1999-2004. We first estimate technical efficiencies using Data Envelopment Analysis and test for cross-country differences. Efficiency scores are relatively high for South Korea and relatively low for the Philippines. We then investigate the link between ownership structure and efficiency controlling for various factors such as size, risk and the economic environment. We find that efficiency scores are higher for banks which are held by minority private shareholders and banks that are foreign-owned

Ownership Structure and Bank Efficiency in the asia pacific region

This paper focuses on efficiency measures of banks from six countries in Southeast and East Asia. We use a two-stage approach to study the post-crisis period 1999-2004. We first estimate technical efficiencies using Data Envelopment Analysis and test for cross-country differences. Efficiency scores are relatively high for South Korea and relatively low for the Philippines. We then investigate the link between ownership structure and efficiency controlling for various factors such as size, risk and the economic environment. We find that efficiency scores are higher for banks which are held by minority private shareholders and banks that are foreign-owned

Effects of transhumance route on the richness and composition of bird communities in Tsimanampesotse National Park

In southwestern Madagascar, livestock (cattle) is a major source of income for the human population and is of tremendous cultural importance. In this subarid region, the farming system faces an extreme climate and has to cope with little food and water resources for several months a year. Local farmers overcome these difficulties in the form of transhumance and roaming of cattle in the forest at Tsimanampesotse National Park. The former strategy uses routes directly through the park twice per year. To assess possible effects of the transhumance and associated human activities on birds, we compared the composition and abundance of birds at one control site and two sites along the trail of transhumance in the forest of Tsimanampesotse National Park from January to May 201 2. The results showed that the abundance of birds declined near the trail of transhumance. Ten species of birds were hunted during the transhumance to meet the daily needs of the herders. We interpret the lower density of birds along the trail of transhumance as a consequence of hunting, especially for large and terrestrial birds such as Coua spp. Cattle activities (trampling, grazing) do not seem to bird communities

Perceptions de la variabilité climati que et stratégies d’adaptation dans le système oasien de Gouré (Sud-est Niger)

Les savoirs liés au temps et à l’espace, et l’identification des stratégies paysannes pour affronter les problèmes climatiques sont indispensables pour toute compréhension des questions climatiques. Pour mieux apprécier les perceptions de la variabilité climatique et les stratégies d’adaptation utilisées, une enquête semi structuré qui a concerné 60 personnes repartie dans 4 villages du département de Gouré, situé dans l’Est du Niger est conduite selon une approche qualitative et quantitative. Les effets de la variabilité climatique ressentis par les agriculteurs sont l’aridité du climat, l’augmentation de la température et le caractère aléatoire des pluies. Les éleveurs la perçoivent de façon indirecte à travers la réduction du fourrage et de la disponibilité d’eau. Ces effets ont poussé ces populations à adopter des stratégies d’adaptation comme la recherche de nouvelles variétés à cycle court et supportant les poches de sécheresse, la pratique des techniques de fixation des dunes pour la restauration du couvert herbacé, l’utilisation de la fumure organique, la modification des dates de semis, le stockage de fourrage, le déstockage des animaux pendant la soudure, les prières collectives de demande de pluies. Elles sont toutefois insuffisantes du fait de la persistance des effets négatifs de la variabilité climatiques au Niger.Mots clés: Variabilité climatique, perception, stratégies d’adaptation, Gouré, NigerEnglish Title: Farmers perception and adaptation strategies to climate change in the oasis system of Goure (Southeast Niger)English AbstractKnowledge related to the perception of time and space, and identification of farmers’ strategies for dealing with climate change is a perequisite for a good understanding of climate issues. Farmers’ climate variability perceptions and adaptation strategies was studied using a survey conducted with sixty (60) farmers in the department of Gouré, located in eastern Niger. Results showed that farmers directly experience changes in  climate variability through temperature increase, frequent drought and erratic rainfall. By contrast, herders sense the effects of climate change indirectly through fodder reduction and scarce water availability. These effects have prompted farmers to adopt coping strategies such as the use of improved varieties, early and drought tolerant, sand dune stabilization and land reclamation, use of organic manure, changing of planting dates, storage of fodder, the destocking of animals during drought periods, collective prayers for rain. These strategies, however, appear to be insufficient for addressing the negative effects of climate change in this part of Niger.Keywords: climate variability, perception, strategies of adaptation, Goure, Nige

Effects of Ebola epidemic on obstetrical emergencies and outcomes in the region of Kindia, Guinea

Background: Maternal mortality is still high in Guinea despite a decline from 724 to 550 maternal deaths per 100,000 live births between 2012 and 2018. The proportion of births attended by skilled personnel is estimated at 45%. The objective of this study was to assess the effect of Ebola virus disease (EVD) epidemic on the frequency of absolute maternal indications, as well as the outcomes of these interventions for mother and child in the region of Kindia.Methods: This was a longitudinal study using 20 months of retrospective data collected in the pre-Ebola (March to December 2012 and March to December 2013) and intra-Ebola (March to December 2014 and March to December 2015) periods. The proportions of maternal health indicators in both study periods were compared using a significance level of 0.05.Results: A total of 1747 women were included in this study. The proportion of women who received a major obstetric procedure in Kindia regional hospital was 85% in each pre and post Ebola periods. Ebola, however, contributed to a significant increase in maternal deaths.Conclusions: The Ebola epidemic has contributed to a significant increase in maternal deaths in health facilities. Measures encouraging health workers to manage obstetric emergencies during critical periods would be necessary