Revue Africaine des Sciences Sociales et de la Sante Publique https://www.ajol.info/index.php/rasp <p>Created in January 2010 by a multidisciplinary team of African and European Sociologists, Anthropologists, Doctors, Pharmacists, Psychologists and Psychoanalysts, the RASP is a Pan-African open-access journal.<br />RASP is an open-access journal, which means all its content is freely available without charge to the user or their institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles or use them for any other lawful purpose without asking prior permission from the publisher or the author as long as they cite the source. Since January 2018, the RASP has been published by Bamako Institute for Research and Development Studies Press.<br /><br /><strong>Aims and Scope</strong><br />RASP aims to create a fund of valuable documentation in public health, social sciences and humanities for students, teachers, policy makers and researchers who find support for disseminating their work in French or English. <br /><br />You can view this journal's website <a href="https://revue-rasp.org/index.php/rasp/index" target="_blank" rel="noopener">here</a>.<br /><br /><br /></p> en-US revueraspi@gmail.com (Pr Olivier Douville) mkante@revue-rasp.org (Dr Mahamadou Kante) Tue, 16 Jun 2026 18:13:14 +0000 OJS 3.3.0.11 http://blogs.law.harvard.edu/tech/rss 60 Assessing the medical costs of COVID-19 inpatients in 2021 at Bogodogo University Hospital, Ouagadougou, Burkina Faso https://www.ajol.info/index.php/rasp/article/view/325379 <p><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 89.8019px; top: 671.278px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.997794);">COVID</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 153.002px; top: 671.278px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.883258);">-19 est une infection émergente de type zoonose virale causée par le coronavirus SAR</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 831.502px; top: 671.278px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.932916);">S-CoV2. </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0011px; top: 697.778px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.900635);">Sur le plan économique, elle a imposé d’importants frais médicaux aux patients</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 721.703px; top: 697.778px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.904954);"> liés à l’ampleur et aux </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0011px; top: 724.178px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.880691);">complications y afférentes. Peu de données sont disponib</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 540.099px; top: 724.178px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.864343);">les dans les pays à revenus faibles et africains. </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0011px; top: 750.678px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.877232);">Notre étude a pour objectif d’évaluer le coût médical direct supporté par le</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 722.899px; top: 750.678px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.859599);">s patients hospitalisés </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0011px; top: 777.078px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.921193);">atteints de COVID</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 238.401px; top: 777.078px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.877274);">-19 au Burkina Faso. Nous avons réalisé une étude transversale analytique au centre </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0009px; top: 803.578px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.97587);">d’iso</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 130.101px; top: 803.578px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.929155);">lement COVID</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 265.401px; top: 803.578px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.878723);">-19 du Centre Hospitalier Universitaire de Bogodogo. Les données </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0013px; top: 829.978px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.863898);">démographiques et cliniques des patients de l’année 2021 ont été recueillies à partir des d</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 847.8px; top: 829.978px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.837999);">ossiers </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0013px; top: 856.378px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.878283);">médicaux physiques ; celles financières ont été obtenues à partir de la facturat</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 700.301px; top: 856.378px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.894219);">ion des coûts de l’hôpital. </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0013px; top: 882.878px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.859557);">Nous avons utilisé la méthode d'établissement des coûts ascendante pour calcule</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 760.196px; top: 882.878px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.863318);">r le coût médical </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0013px; top: 909.277px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.925368);">direct. Une régression linéaire a permis d’identifier les facteurs du coût médical d</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 751.401px; top: 909.277px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.914331);">irect. Nos résultats </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0013px; top: 935.777px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.849087);">révèlent que le coût médical moyen est de 187 631 FCFA, avec un écart</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 695.101px; top: 935.777px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.842071);">-type de 93 519. Le coût </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0009px; top: 962.178px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.920757);">médical élevé est associé à l'âge, la comorbidité, la profession artisane et la durée d’h</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 790.593px; top: 962.178px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.93025);">ospitalisation. </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0009px; top: 988.678px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.887136);">Les coûts des médicaments et des examens biologiques constituent les dépenses majeures avec 68</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 879.891px; top: 988.678px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.962059);"> % </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0009px; top: 1015.08px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.872003);">et 15 % du coût médical direct total. Le coût médical direct supporté par les patie</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 785.999px; top: 1015.08px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.847029);">nts atteints de </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0009px; top: 1041.58px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.997794);">COVID</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 153.201px; top: 1041.58px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.917011);">-19 est très élevé par rapport au salaire minimum. Ce coût est associé à un âge avancé, aux </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0009px; top: 1067.98px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.902473);">comorbidités, à la profession et à une augmentation de la durée d’hospitalisation.</span></p> Yugbaré Belemsaga Danielle, KEITA Bantji dite Mama, Cissé Kadari, Ouédraogo Henri Gautier, Kouanda Seni Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/325379 Tue, 16 Jun 2026 00:00:00 +0000 Effect of the 13-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of vaccine serotypes in West Africa: a narrative review https://www.ajol.info/index.php/rasp/article/view/325665 <p><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.3548px; top: 93.5573px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.876028);">Assessing the impact of the 13</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 224.501px; top: 93.5573px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.889922);">-valent pneumococcal conjugate vaccine (PCV13) on </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4658px; top: 108.192px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.880933);">nasopharyngeal carriage of pneumococcal vaccine types (V</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 339.911px; top: 108.192px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.895173);">T) in </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 368.016px; top: 108.192px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.890566);">West Africa allows us to </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4657px; top: 122.881px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.900367);">monitor carriage dynamics.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 190.743px; top: 122.881px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.854537);"> We conducted a </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 274.723px; top: 122.881px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.915808);">narrative</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 314.191px; top: 122.881px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.88847);"> review of studies in West Africa to </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4654px; top: 137.515px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.896203);">summarize the impact of PCV13 on </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 240.965px; top: 137.515px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(1.04065);">VT</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 255.71px; top: 137.515px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.877072);"> carriage. Impact measures were estimated using </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4659px; top: 152.205px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.867698);">indicators such as prevalence ratio, odds ratio and relative</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 334.756px; top: 152.205px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.877767);"> risk. From an initial pool of 72 </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4662px; top: 166.839px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.922326);">articles, four studies met the criteria. The included studies spanned from </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 394.291px; top: 166.839px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.899561);">200</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 410.921px; top: 166.839px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.925219);">0 to 2025. Since </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4662px; top: 181.529px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.854234);">the introduction of PCV13 in 2011, there has been a consistent and substantial reduc</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 454.656px; top: 181.529px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.87147);">tion in </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4662px; top: 196.163px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.888485);">carriage of vaccine serotypes among</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 226.331px; top: 196.163px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.904374);"> children, the target population for vaccination, and among </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4661px; top: 210.797px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.921872);">adults due to the indirect effect of conjugate vaccines. Estimates of reductions in </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 430.932px; top: 210.797px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(1.04065);">VT</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 445.621px; top: 210.797px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.90252);"> carriage </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4656px; top: 225.487px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.876799);">ranged from </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 125.942px; top: 225.487px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.863234);">30% to </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 163.691px; top: 225.487px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.91617);">74%.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 186.807px; top: 225.487px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.880674);"> The introduction of PCV13 is associated with a significant and </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4654px; top: 240.121px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.870889);">sustained</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 106.763px; top: 240.121px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.867391);"> decrease in nasopharyngeal carriage of vaccine pneumococcal serotypes in West </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4654px; top: 254.81px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.931221);">Africa, heralding a reduction in </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 207.704px; top: 254.81px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(1.04065);">VT</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 222.449px; top: 254.81px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.939337);">-related morbidity and mortality. </span></p> Mamadou Bountogo, Abdoulaye Sawadogo, Félicité W. Nana, Yliassa Barry, Nicolas Meda Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/325665 Tue, 16 Jun 2026 00:00:00 +0000 Systematic review of healthcare pathways for people with reduced mobility in Benin and Sub-Saharan Africa https://www.ajol.info/index.php/rasp/article/view/325667 <p>In sub-Saharan Africa, the healthcare context is quite unique. To assess the healthcare pathways of people with reduced mobility, analyze their evolution, and understand the difficulties they face in accessing healthcare services, we believe it is essential to begin with a review of these pathways. The study is a scoping review followed by a causal analysis. The articles were processed using Zotero 5.0.96.3. The search equations were established using the Population-Intervention-Comparison-Outcomes (PIE) method. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRITEM) method was used to ensure transparency and comprehensiveness of the review. The analysis of the results was qualitative. Twenty-eight articles were selected. In the population, healthcare pathways do not begin in hospitals but include traditional, religious, and community-based approaches. Traditional considerations dominate the pathways encountered, and recourse to modern healthcare is a last resort. The increasing complexity of healthcare pathways is a real and lived experience. Communication, education, and information for health must be a priority for public health policies. Various authors have noted some gaps in the public's understanding of their own illnesses. In comparison, non-pharmacological approaches and non-conventional healthcare practices exist elsewhere. Measures to facilitate access to healthcare information and bring healthcare services closer to the population are essential. This study explores the current situation regarding therapeutic choices. The causal analysis of the situation reveals much about the findings.</p> Tychique NOUGBODE, Charles-Patrick Makoutode, Cyriaque Degbey, Maurice Agonnoude, Charles Jerôme Sossa Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/325667 Tue, 16 Jun 2026 00:00:00 +0000 Parental communication on sexual and reproductive health with their adolescents and associated factors in the city of Ouagadougou, Burkina Faso. https://www.ajol.info/index.php/rasp/article/view/325668 <p><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 117.899px; top: 153.478px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.87995);">Communication between parents and their adolescents regarding sexual and repro</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 762.589px; top: 153.478px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.89475);">ductive health </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.101px; top: 179.878px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.9307);">is crucial for maintaining adolescent </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 444.001px; top: 179.878px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.995541);">well</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 478.401px; top: 179.878px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.916871);">-being. This study aimed to evaluate parental </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.101px; top: 206.378px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.884922);">communication with their adolescents regarding sexual and reproductive health</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 777.198px; top: 206.378px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.858034);"> (SRH) and </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.101px; top: 232.778px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.863517);">associated factors in Ouagadougou. A cross</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 481.001px; top: 232.778px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.87597);">-sectional study was conducted with parents of </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.101px; top: 259.278px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.851047);">adolescents aged 10 to 19 years in Ouagadougou, using a cluster sampling. The dependent </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.101px; top: 285.678px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.902004);">variable was parent</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 294.601px; top: 285.678px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.904128);">–adolescent communication about SRH. Associated factors were </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.101px; top: 312.178px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.873274);">determined using modified Poisson regression.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 500.601px; top: 312.178px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.844158);"> Of the 453 parents included, 50.6% </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 807.498px; top: 312.178px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.894448);">reported </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.1px; top: 338.578px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.92593);">communicating</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 242.6px; top: 338.578px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.986997);"> with thei</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 320.5px; top: 338.578px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.927357);">r adolescents about SRH, with 63.8% initiating the discussions. The </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.1px; top: 365.078px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.92144);">two main reasons for not communicating with adolescents were embarrassment (39.1</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 815.601px; top: 365.078px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.943033);">%) and </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.1px; top: 391.478px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.921543);">cultural taboos (35.4%). Multivariate analysis revealed that parent</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 652.8px; top: 391.478px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.911996);">-adolescent communication </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.099px; top: 417.978px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.879514);">about SRH occurs more frequently among mothers (adjusted prevalence ratio (AP</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 805.398px; top: 417.978px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.874594);">R): 1.48 </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.099px; top: 444.378px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.912654);">(1.19–1.86)</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 211.499px; top: 444.378px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.857284);">), older parents (APR: 1.53 (1.19</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 483.101px; top: 444.378px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.909199);">–1.97)</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 534.699px; top: 444.378px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.841402);">), and parents with a better knowledge of </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.099px; top: 470.878px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.885119);">SRH (APR: 2.63 (1.27</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 306.999px; top: 470.878px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.909187);">–5.44)</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 358.599px; top: 470.878px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.872171);">). Although sex education i</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 583.599px; top: 470.878px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.864442);">s important for adolescents, half of </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.099px; top: 497.278px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.85988);">parents do not communicate with their children about SRH topics. It is essent</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 761.297px; top: 497.278px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.855173);">ial to develop </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.099px; top: 523.678px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.891296);">strategies that promote effective communication between parents and their adole</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 800.389px; top: 523.678px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.857216);">scents to </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.099px; top: 550.178px; font-size: 20px; font-family: sans-serif; transform: scaleX(0.874014);">enhance adolescent health.</span></p> Abou Coulibaly, Alimata Sadia Zeba, Jeoffray Diendéré, Halima Tougri, Seni Kouanda Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/325668 Tue, 16 Jun 2026 00:00:00 +0000 Maternal mortality: epidemiology of third delay in pregnant women referred to two hospitals in Cotonou (Benin) between 2017 and 2021 https://www.ajol.info/index.php/rasp/article/view/325795 <p>Despite positive progress, Benin still has unsatisfactory indicators on maternal health. This work aimed to identify the determinants associated with the third delay in two reference hospitals. A retrospective descriptive and analytical study, conducted in 2024 at the University Clinic of Gynaecology and Obstetrics of CNHU HKM and at the Lagune Mother and Child University Hospital, included allmaternal deaths of referred patients occurring between 2017 and 2021. Intra-hospital maternal mortality rate was 2039 per 100,000 live births. The mean age was 29.6 years ± 6.7. Alteration of the general condition on admission (OR = 0.46 [0.31-0.68]), alteration of consciousness (OR = 0.51 [0.55-0.75]), and hemorrhagic causes (OR = 0.45 [0.30-0.67]) were associated with faster treatment. Conversely, infectious causes (OR = 2.42 [1.03-6.34]) were significantly associated with a higher probability of occurrence of the 3rd delay. The severity factors presented at admission by referred women determine the speed of care. However, our results demonstrate that infectious causes alsopresent a risk that must be taken into account</p> Sètondji Géraud Roméo Padonou, Généreuse Beheton, Jennifer Olofindji, Christiane Tshabu Aguemon, Badirou Aguemon Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/325795 Tue, 16 Jun 2026 00:00:00 +0000 Perception of socio-professional categories on the sexuality and sexual practices of young people and adolescents through the interventions of the Centres des Jeunes Amour & Vie (CJAV) of the department of Zou, Benin https://www.ajol.info/index.php/rasp/article/view/325793 <p>Social norms through taboos in the Abomey region are partly hindering the implementation of interventions related to adolescent and young people's sexual health. In other areas, this context limits access to sex education and information and neglects the needs of adolescents. The creation of Young Love &amp; Life Centres (CJAV) in the municipality of Zou aims to provide access to sex education information. However, discussions have revealed deep tensions regarding perceptions and acceptance of the CJAV. Our study aims to understand the perceptions of different socio-professional categories regarding CJAV interventions. In November 2024, semi-structured interviews were conducted with 45 respondents purposively selected fromthe municipalities where the interventions took place. An interview guide was used to collect qualitative data, which was analysed using Dedoose software. The results highlight three types of perceptions: positive, negative and mixed. It is therefore necessary to develop an educational program that takes into account the needs of young people and other social groups. Such a program could improve the acceptability, efficacy and even efficiency of interventions in similar contexts.</p> Sêmêvo Yves Roland Frejus, Sabine T. TOUNGAKOUAGOU SAMA, Géraud PADONOU, Anthelme AGBODANDE, Thierry Armel ADOUKONOU Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/325793 Tue, 16 Jun 2026 00:00:00 +0000 Factors in the spread of Buruli ulcer and urinary bilharziasis and coping strategies of communities living along the Subiakro and Kossou hydro-agricultural schemes https://www.ajol.info/index.php/rasp/article/view/325796 <p>Why do Buruli ulcer and urinary bilharziasis persist in the Subiakro and Kossou localities, and how are people coping? To answer this question, a study was carried out in the Yamoussoukro health district, an endemic area for Buruli ulcer and urinary bilharziasis, with a view to analysing the factors involved in the spread of these diseases and the communities' coping strategies. The study was qualitative in nature, involving observations, semi-directive interviews and focus group discussions using the Accelerated Participatory Research Method. A total of sixteen interviews were conducted with men, women, young people, community leaders, nurses and doctors. Socio-economic and cultural activities, plant wounds/stings and occult practices were identified as factors in the spread of Buruli ulcer and bilharzia. Traditional and modern care are the communities' care and coping strategies. At the same time, the community has no means of combating the disease, and prevention policies are non-existent. Hence the need for policies adapted to the realities of the communities in order to drastically reduce the incidence of these diseases in these areas</p> KOUAME ARISTIDE BROU Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/325796 Tue, 16 Jun 2026 00:00:00 +0000 Factors associated at COVID-19 vaccination among health workers in Mali's university hospitals in 2023 https://www.ajol.info/index.php/rasp/article/view/326564 <p><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4098px; top: 80.5864px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.998368);">COVID</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 100.443px; top: 80.5864px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.881022);">-19, an infectious disease caused by SARS</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 287.694px; top: 80.5864px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.999348);">-CoV-</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 315.964px; top: 80.5864px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.881279);">2, is </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 336.585px; top: 80.5864px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.897115);">vaccine</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 370.288px; top: 80.5864px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.900689);">-preventable</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 425.72px; top: 80.5864px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.931532);">. Vaccination </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4099px; top: 95.2204px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.924627);">coverage is low despite the availability of several vaccine types</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 351.33px; top: 95.2204px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.928788);">. This study aimed</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 434.811px; top: 95.2204px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.986946);"> to identify </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4098px; top: 109.855px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.881836);">the </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 81.0416px; top: 109.855px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.91111);">factors associated with COVID</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 217.96px; top: 109.855px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.901203);">-19 vaccination among health workers in university hospitals </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4098px; top: 124.489px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.970546);">(CHU).</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 98.8912px; top: 124.489px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.901215);"> We conducted a cross</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 200.332px; top: 124.489px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.922546);">-sectional analytical stu</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 305.986px; top: 124.489px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.921211);">dy from 1 January to 30 June 2023. We</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4095px; top: 139.234px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.922074);">interviewed health workers at the CHU </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 242.573px; top: 139.234px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.935487);">National </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 283.482px; top: 139.234px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.882461);">Centre</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 312.86px; top: 139.234px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.970006);"> for </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 331.485px; top: 139.234px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.914841);">odontostomatology </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 420.066px; top: 139.234px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.950535);">(CNOS), Kati, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4098px; top: 153.868px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.973536);">Mali Hospital</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 133.148px; top: 153.868px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.900353);">, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 145.122px; top: 153.868px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.960257);">African Institute of Tropical Ophthalmology </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 377.718px; top: 153.868px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(1.02043);">(IOTA), </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 423.502px; top: 153.868px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.958589);">Mother-Child </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4093px; top: 168.502px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.92876);">Luxembourg</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 122.616px; top: 168.502px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.853351);">, Point G</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 164.633px; top: 168.502px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.869325);">, and Gabriel Touré using a questionnaire. We performed multivariate </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4093px; top: 183.136px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.904791);">analysis using Epi</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 145.676px; top: 183.136px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.889378);">-info 7 and SPSS 2022.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 248.669px; top: 183.136px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.933529);"> In total</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 282.594px; top: 183.136px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.899966);">, 277 people were interviewed. The 18</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 451.663px; top: 183.136px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.872563);">-29 age </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4093px; top: 197.881px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.923713);">group was approximately 41%. The median age years was 32 (IIQ [Q1=1; Q3=3]). In </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4093px; top: 212.516px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.905972);">multivariate a</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 127.826px; top: 212.516px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.958725);">nalysis, age ≥ 30 years (ORa = 1.79 (95% CI [1.03</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 365.41px; top: 212.516px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.855666);">-3.13]) ; p = 0.040), good </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4093px; top: 227.15px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.918543);">appreciation of the vaccine (ORa = 3.15 (95% CI [1.02</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 310.091px; top: 227.15px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.928465);">-9.69]) ; p = 0.045), belief (ORa = 4.13 </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4097px; top: 241.784px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.960623);">(95% CI [1.66</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 130.488px; top: 241.784px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.952481);">-10.03]); p = 0.002)</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 220.51px; top: 241.784px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.95121);">, and vaccinator qualification (ORa = 3.54 (95% CI [1</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 466.852px; top: 241.784px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.924955);">.95-</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4097px; top: 256.529px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.924644);">6.45]); p = 0.0001) were associated with vaccination against COVID</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 372.616px; top: 256.529px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.927721);">-19. Age, appreciation of </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4098px; top: 271.163px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.940336);">vaccination, belief in vaccination</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 214.301px; top: 271.163px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.929448);">, and vaccinator qualification were associated with </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 445.565px; top: 271.163px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(1.00122);">COVID</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 480.709px; top: 271.163px; font-size: 11.0865px; font-family: sans-serif;">-</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.41px; top: 285.797px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.925119);">19 vaccination. These results would explain the low COVID-</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 337.14px; top: 285.797px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.897734);">19 vaccination coverage rate. </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.41px; top: 300.431px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.906795);">We recommend strengthening communication with health workers aged 30 years or younger </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.41px; top: 315.065px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.923578);">and ensuring the availability of qualified vaccinators. </span></p> Hanine Keita, Oumar Sangho, Nouhoum Telly, Cheick Abou Coulibaly, Yaya Ibrahim Coulibaly Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326564 Tue, 16 Jun 2026 00:00:00 +0000 Technical and operational performance of solar refrigerators in cold chain systems in Africa: a systematic review https://www.ajol.info/index.php/rasp/article/view/326567 <p><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.3004px; top: 93.5572px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.908926);">Cold chain systems are essential for preserving medical products, particularly</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 410.095px; top: 93.5572px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.877487);"> vaccines, across </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4114px; top: 108.192px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.888877);">Africa. However, chronic dysfunctions severely compromise their effectiveness, w</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 441.247px; top: 108.192px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.869448);">ith nearly </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4114px; top: 122.826px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.910484);">50% of vaccines losing potency due to cold chain failures, and 30–</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 362.643px; top: 122.826px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.924699);">40% of healthcare facilities </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4114px; top: 137.46px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.917101);">lacking functional equipment. This systematic review</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 301.442px; top: 137.46px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.890998);"> aims to evaluate cold chain performance, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4112px; top: 152.094px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.898168);">identify gaps, and propose practical solutions.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 280.602px; top: 152.094px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.922155);"> Following PRISMA guidelines, 36 articles </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4108px; top: 166.839px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.923526);">covering 18 African countries and 7,238 healthcare facilities (65% in rural</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 425.055px; top: 166.839px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.880716);"> areas) were </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4108px; top: 181.473px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.910385);">analyzed. Data sources included natio</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 235.921px; top: 181.473px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.923723);">nal assessments (EVM), technical audits, and mixed or </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4108px; top: 196.107px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.888836);">qualitative studies. Key indicators assessed were equipment functionality, tempe</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 458.764px; top: 196.107px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.865345);">rature </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4108px; top: 210.741px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.89064);">compliance, energy sources, and maintenance. Data synthesis was performed using R sof</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 459.761px; top: 210.741px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.907578);">tware </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4108px; top: 225.376px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.870558);">with a random</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 131.375px; top: 225.376px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.887478);">-effects mo</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 182.595px; top: 225.376px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.909783);">del.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 198.892px; top: 225.376px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.849593);"> Results showed that only 61.2% of cold chain equipment was </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.411px; top: 240.12px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.915271);">functional, with significant disparities: 73% in urban areas versus 54% in rural zones. T</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 453.776px; top: 240.12px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.906239);">hermal </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.411px; top: 254.755px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.895819);">compliance was especially low in rural areas (36%), and prolonged breakdowns (up to 57 days) </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.411px; top: 269.389px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.924616);">wer</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 81.9299px; top: 269.389px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.922739);">e common due to lack of maintenance. Solar refrigerators performed better (</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 426.835px; top: 269.389px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.934092);">82% thermal </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.411px; top: 284.023px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.905517);">stability), but adoption remains limited. These shortcomings lead to vaccine losse</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 425.06px; top: 284.023px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.898493);">s (up to 17%) </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.411px; top: 298.768px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.8644);">and preventable outbreaks.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 186.809px; top: 298.768px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.856931);"> Targeted investments are urgently needed to im</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 408.537px; top: 298.768px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.869799);">prove equipment </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4109px; top: 313.402px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.894717);">availability, staff training, and maintenance, with a focus on renewable energy and sm</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 472.843px; top: 313.402px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.865472);">art </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4109px; top: 328.036px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.902833);">technologies. Public policies must incorporate dedicated budgets and harmonized standards to </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4109px; top: 342.67px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.893305);">ensure long-</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 120.4px; top: 342.67px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.91465);">term sustainability of cold chain systems</span></p> Sègbégnon Rigobert MISSIKPODE, Makoutodé Charles Patrick, DEGBE Cyriaque Comlanet, PARAISO Moussiliou Noël, JOHNSON Roch Christian Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326567 Tue, 16 Jun 2026 00:00:00 +0000 Influence of the Social Gradient on Fertility in Sub-Saharan Africa: A Systematic Review https://www.ajol.info/index.php/rasp/article/view/326659 <p><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.2176px; top: 95.0576px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.952234);">Fertility in sub</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 144.428px; top: 95.0576px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.890478);">-Saharan Africa remains a major challenge, shaped by deep</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 446.328px; top: 95.0576px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.90997);">-rooted social </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3346px; top: 108.572px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.854978);">disparities. This synthesis explores the impact of the social gradient, the invers</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 449.034px; top: 108.572px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.85832);">e relationship </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3346px; top: 122.086px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.886067);">between socioeconomic status and health, on reproductive behaviour in the region. The anal</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 495.336px; top: 122.086px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.875139);">ysis </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3346px; top: 135.601px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.90879);">is based on </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 126.918px; top: 135.601px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.899274);">226 </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 148.306px; top: 135.601px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.913699);">documents selected from </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 271.229px; top: 135.601px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.899274);">831 </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 292.616px; top: 135.601px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.907526);">publications released between </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 439.04px; top: 135.601px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.911216);">2000 and 2025</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 510.49px; top: 135.601px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.917939);">. </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3344px; top: 149.115px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.891514);">The results reveal a complex social gradient closely linked to fertility dynamic</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 457.615px; top: 149.115px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.859233);">s. Women</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 505.68px; top: 149.115px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.936576);">’s </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3348px; top: 162.63px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.90544);">education has emerged as the most frequently reported determinant, mentioned in nearly</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 488.637px; top: 162.63px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.92696);"> 77% </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3348px; top: 176.144px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.888301);">of the studies, confirming its central role in birth reduction. Improved living standards a</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 504.387px; top: 176.144px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.816834);">re </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3348px; top: 189.658px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.871715);">associated with a decrease in the number of children, consistent with classic de</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 463.254px; top: 189.658px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.897812);">mographic </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3348px; top: 203.173px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.914464);">transition models. Spatial disparities remain significant, particul</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 367.943px; top: 203.173px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.905362);">arly the </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 405.783px; top: 203.173px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.870639);">gap between urban and </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.334px; top: 216.687px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.909608);">rural areas, which reaches up to 2.7 children per</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 298.021px; top: 216.687px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.943852);"> total fertility rate. Other factors contribute to </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3342px; top: 230.202px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.920448);">these dynamics, notably still</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 204.008px; top: 230.202px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.912);">-limited access to contraception (</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 360.658px; top: 230.202px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.912697);">29% </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 385.337px; top: 230.202px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.949088);">of women in </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 448.561px; top: 230.202px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.899161);">2019</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 472.064px; top: 230.202px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.899519);">) and the </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3346px; top: 243.716px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.903533);">gradual increase in the age of</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 209.297px; top: 243.716px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.91606);"> marriage. Altogether, these findings show that the demographic </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3347px; top: 257.231px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.90392);">transition in sub</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 143.724px; top: 257.231px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.896506);">-Saharan Africa is far from uniform and remains </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 368.532px; top: 257.231px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.908267);">closely tied to</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 433.166px; top: 257.231px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.885183);"> social, economic, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3347px; top: 270.745px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.856343);">and territorial conditions. Given these observations, it is essential to design targe</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 458.553px; top: 270.745px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.858533);">ted policies </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3347px; top: 284.259px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.871609);">that promote education, access to reproductive healthcare, and information, while i</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 471.833px; top: 284.259px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.925669);">nvolving </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 69.3347px; top: 297.774px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.901615);">religious and cultural figures in awareness campaigns to reduce these dispariti</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 436.226px; top: 297.774px; font-size: 11.7517px; font-family: sans-serif; transform: scaleX(0.825281);">es. </span></p> Fousséni Seibou, Charles-Patrick Makoutodé, Alphonse Kpozehouen, Yolaine Glèlè-Ahanhanzo, David Houéto Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326659 Tue, 16 Jun 2026 00:00:00 +0000 Factors influencing the delegation of health tasks to community actors in two health districts facing security challenges, Burkina Faso, 2024 https://www.ajol.info/index.php/rasp/article/view/326662 <p><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.2995px; top: 91.4512px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.971965);">In </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 78.6033px; top: 91.4512px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.881821);">the </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 96.2309px; top: 91.4512px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.872955);">context of </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 146.342px; top: 91.4512px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.861625);">a security crisis, marked by a reduction in the provision of care in health </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4103px; top: 104.201px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.91368);">facilities, delegating tasks to community actors appears to be an alternative. </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 407.317px; top: 104.201px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.941713);">This</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 427.051px; top: 104.201px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.917107);"> study </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 457.317px; top: 104.201px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.894918);">aimed</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4103px; top: 116.95px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.871607);">to explore the factors influencing the continuity of basic care provided by community</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 455.658px; top: 116.95px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.854881);">-based </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4109px; top: 129.699px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.869583);">health workers and village birth attendants in </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 277.498px; top: 129.699px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.881703);">the </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 295.123px; top: 129.699px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.901893);">context of insecurity.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 391.022px; top: 129.699px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.842652);"> This cross</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 441.353px; top: 129.699px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.908911);">-sectional </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4112px; top: 142.449px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.926297);">qualitative study </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 147.563px; top: 142.449px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.875934);">was </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 170.511px; top: 142.449px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.910419);">conducted in the health districts of Ouargaye and Bittou between </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4114px; top: 155.198px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.905358);">December 2023 and January 2024. Semi</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 248.338px; top: 155.198px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.922835);">-structured interviews were cond</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 395.678px; top: 155.198px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.960998);">ucted with sixty</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 467.85px; top: 155.198px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.955293);">-six </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4115px; top: 167.947px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.863239);">people. The interviews were </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 198.006px; top: 167.947px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.896537);">manually transcribed</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 292.462px; top: 167.947px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.859659);"> using </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 324.28px; top: 167.947px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.871773);">Microsoft Word. Data analysis was </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4113px; top: 180.697px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.922738);">performed using </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 142.131px; top: 180.697px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.981167);">NVivo</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 171.619px; top: 180.697px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.924556);"> 14 software.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 230.378px; top: 180.697px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.916583);"> The results </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 286.254px; top: 180.697px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.880616);">revealed</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 323.726px; top: 180.697px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.951504);"> that continuity of care is facilitated </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4112px; top: 193.446px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.924114);">by organizational factors (accessibility</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 245.788px; top: 193.446px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.879976);"> and</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 267.518px; top: 193.446px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.929868);"> availability of resources), community factors </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4114px; top: 206.196px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.933414);">(support and satisfaction), intrapersonal factors (motivation), and policy fact</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 409.762px; top: 206.196px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.94716);">ors (reduction in </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4114px; top: 218.945px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.937734);">morbidity and mortality). </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 179.16px; top: 218.945px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.953371);">Ho</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 192.685px; top: 218.945px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.911128);">wever</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 219.181px; top: 218.945px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.900292);">, the main obstacles identified include insufficient resources, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4116px; top: 231.695px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.926239);">transportation difficulties, insecurity, low financial motivation, and community rel</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 447.79px; top: 231.695px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.867688);">uctance. </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4116px; top: 244.444px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.875954);">Participants suggested concrete actions</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 237.03px; top: 244.444px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.913922);">, such as providing transportation, improving motivatio</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 479.051px; top: 244.444px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.890959);">n, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4116px; top: 257.194px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.866045);">enhancing supervision, and integrating task delegation into institutional processes </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 438.808px; top: 257.194px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.810963);">to address </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4116px; top: 269.943px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.872556);">these challenges</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 138.028px; top: 269.943px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.918444);">. These results highlight the need for strong systemic and community support </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4116px; top: 282.692px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.907377);">to sustain healthcare in fragile </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 201.775px; top: 282.692px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.896631);">regions</span></p> Morou NIKIEMA , Noël K.P. KABORE, Moussa ISSA LENDE, Paul ZONGO, Issa GUIRE Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326662 Tue, 16 Jun 2026 00:00:00 +0000 Social and Cultural perceptions of Antenatal Care among Pregnant Women and Their Husbands in Maniema Province, Democratic Republic of the Congo https://www.ajol.info/index.php/rasp/article/view/326663 <p><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4097px; top: 78.5907px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.904787);">Antenatal care is a fundamental component of reproductive health and a key lever for r</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 449.337px; top: 78.5907px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.90247);">educing </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4097px; top: 91.3401px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.93906);">maternal and neonatal morbidity and mortality.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 278.603px; top: 91.3401px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.940263);"> This study, conducted in Maniema Province, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4096px; top: 104.09px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.892191);">aims to analyse social and cultural perceptions of antenatal care to identify </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 394.124px; top: 104.09px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.912121);">factors that facilitate </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4096px; top: 116.839px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.9003);">or hinder its utilisation</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 170.177px; top: 116.839px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.86163);"> and to propose strategies tailored to the local context. A qualitative </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4095px; top: 129.588px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.884367);">approach was a</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 134.59px; top: 129.588px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.892786);">dopted, based on semi</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 234.699px; top: 129.588px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.915999);">-structured interviews and focus group discussions </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 464.857px; top: 129.588px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.982988);">with </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4092px; top: 142.338px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.883351);">pregnant women and their husbands, enabling</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 266.741px; top: 142.338px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.903867);"> triangulation of perspectives.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 397.007px; top: 142.338px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.900031);"> The findings reveal </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4091px; top: 155.087px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.905285);">an ambivalent perception of antenatal care. On the one hand, it is recognized as ben</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 440.687px; top: 155.087px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.989053);">eficial for </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4091px; top: 167.837px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.93433);">pregnancy monitoring, complication prevention, and the protection of both mother and child. </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4091px; top: 180.586px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.872654);">On the other hand, certain traditional beliefs consider antenatal care unnecessar</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 435.701px; top: 180.586px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.93649);">y, viewing </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4091px; top: 193.336px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.840029);">pregnancy as a natural phenomenon that can be managed throug</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 359.313px; top: 193.336px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.858052);">h traditional care or prayer. </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4091px; top: 206.085px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.892676);">Husbands, who are often the primary decision</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 266.63px; top: 206.085px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.878483);">-makers, play a central role in access to care: their </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4093px; top: 218.835px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.890924);">support facilitates attendance, whereas modesty, fear of HIV testing, or the dele</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 442.687px; top: 218.835px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.904191);">gation of </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4093px; top: 231.584px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.899625);">responsibility to women limit their i</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 230.487px; top: 231.584px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.884655);">nvolvement. The influence of in</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 377.052px; top: 231.584px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.868138);">-laws, religious leaders, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4095px; top: 244.333px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.89816);">and peers is also significant. Strengthening peer education, promoting male involvement, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4095px; top: 257.083px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.930383);">implementing community</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 182.261px; top: 257.083px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.86683);">-based campaigns, and engaging religious leaders emerge as key </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4093px; top: 269.832px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.923628);">strategies for improving </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 174.613px; top: 269.832px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.912669);">the utilization of antenatal care</span></p> José ASSANI TUTU, Imani Ramazani, Léon Cyprien Ngandu wa Ngandu, Marie claire Omanyondo Ohambe Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326663 Tue, 16 Jun 2026 00:00:00 +0000 Quality of care in areas with security challenges: involvement and empowerment of internally displaced persons in Burkina Faso. https://www.ajol.info/index.php/rasp/article/view/326692 <p><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.2992px; top: 65.8412px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.907332);">In response to the security challenges facing Burkina Faso, a health system resil</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 422.952px; top: 65.8412px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.895451);">ience strategy </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4101px; top: 80.5864px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.893364);">has been put in place to strengthen the coordination of health actions and improve the provision </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4101px; top: 95.2204px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.88414);">of care to displaced persons. This study aimed</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 286.476px; top: 95.2204px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.879376);"> to analyse the determinants of healthcare </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4101px; top: 109.855px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.916165);">provision to internally displaced persons in areas facing security challenges. A cr</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 427.054px; top: 109.855px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.822384);">oss</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 441.241px; top: 109.855px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.911105);">-sectional </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4098px; top: 124.489px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.901035);">analytical study was conducted from 6 November to 10 December 2024 at temporary reception</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4098px; top: 139.234px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.942087);">sites for internally dis</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 162.86px; top: 139.234px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.912096);">placed persons in Ouahigouya. A mixed approach to data collection and </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4098px; top: 153.868px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.893744);">analysis was used. It included internally displaced persons and health workers. The quantit</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 462.864px; top: 153.868px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.908447);">ative </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4098px; top: 168.502px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.915112);">sample consisted of 396 internally displaced persons. Quantitative data were proce</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 437.92px; top: 168.502px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.844596);">ssed us</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 470.177px; top: 168.502px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.95572);">ing </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.41px; top: 183.136px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.865602);">R 4.4.1 software.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 143.237px; top: 183.136px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.870087);"> The minimum package of activities offered to internally displaced persons </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4099px; top: 197.881px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.915449);">was incomplete. Care was discontinuous at three</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 285.92px; top: 197.881px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.934961);">-quarters of the reception sites. The level of </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4097px; top: 212.516px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.912523);">internally displaced persons' involvement</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 257.317px; top: 212.516px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.897587);"> in care was low. There</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 372.838px; top: 212.516px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.918529);"> was no framework for </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4095px; top: 227.15px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.920232);">exchanges between beneficiaries and care providers. Factors limiting beneficiar</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 470.065px; top: 227.15px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.925545);">ies' </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4095px; top: 241.784px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.929583);">empowerment in healthcare included low levels of education, limited access to healt</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 478.824px; top: 241.784px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.980947);">h </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4095px; top: 256.529px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.933716);">information and a lack of professional activities.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 299.448px; top: 256.529px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.92082);"> The beneficiar</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 372.616px; top: 256.529px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.903329);">y- centred approach was </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4099px; top: 271.163px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.899127);">insufficiently implemented for internally displaced persons in the security</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 405.767px; top: 271.163px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.853235);">-challenged areas </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4099px; top: 285.797px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.931288);">studied. To </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 118.403px; top: 285.797px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.88251);">achieve</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 152.107px; top: 285.797px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.922505);"> universal health coverage, the quality of care should also extend to these </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4099px; top: 300.431px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.904608);">vulnerable people</span></p> Sayouma Julien SOMA, Hien Hervé, Bacye Y Fidèle, Nana Félicité, Drabo Maxime Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326692 Tue, 16 Jun 2026 00:00:00 +0000 Quality of postoperative care, patient satisfaction, and experience in the otolaryngology department of the Gabriel Touré University Hospital Centre in Bamako https://www.ajol.info/index.php/rasp/article/view/326693 <p>Patient satisfaction and experience in the perioperative setting are positive indicators of quality of care. They influence patient cooperation, which is essential for safe treatment. Therefore, we aimed to address this in this study, with the objective of determining the level of patient satisfaction and experience in the postoperative period within the otolaryngology department of the Gabriel Touré University Hospital in Bamako. Data collection was conducted using a questionnaire adapted to our study context, based on the French National Authority for Health's (HAS) model called the "e-Satis system." The overall patient satisfaction and experience score was 74.62%, and the number of positive results was 70.73%. Patient satisfaction is an undeniable indicator of the quality of care from the patient's perspective, but it remains a subjective factor and can be influenced by several factors such as the quality of technical and interpersonal care, the length of stay, and sociodemographic characteristics that must be taken into account.</p> <p><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4112px; top: 667.837px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.908582);">Patient satisfaction and experience in the perioperative setting are positive indicators of </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4112px; top: 682.582px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.896562);">quality of care. They influence patient cooperation, which is essential for safe treatment. </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4112px; top: 697.216px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.938774);">Therefore, we aimed to address this in this study, with the objective of</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 385.478px; top: 697.216px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.945033);"> determining the leve</span></p> Lassana KEITA , Mohamed Amadou KEITA , Moctar TOUNKARA, Cheick Abou COULIBALY, Hamadoun SANGHO Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326693 Tue, 16 Jun 2026 00:00:00 +0000 Cost-effectiveness analysis of seasonal malaria chemoprophylaxis in children under 5 years of age in the Collines department of Benin in 2025 https://www.ajol.info/index.php/rasp/article/view/326785 <p>Malaria remains a major public health challenge in sub-Saharan Africa, accounting for 40% of consultations and the leading cause of mortality among children under 5 years in Benin. This study aimed to analyze the cost-effectiveness of Seasonal Malaria Chemoprevention (SMC) among children under 5 years in the Collines department of Benin in 2025. This was a cost-effectiveness analysis conducted from March to April 2025, including 454 households selected through multi-stage probability sampling. Data were analyzed using Stata 18.4 and Python 3.10. Univariate and multivariate sensitivity analyses were performed with Monte Carlo simulations over 10,000 iterations. SMC achieved a 19.94% reduction in malaria cases and 32.50% reduction in deaths between 2023 and 2024. The total cost was 246,505,194.5 FCFA. The cost per DALY averted was 123,376 FCFA, 6.5 times below the WHO "very cost-effective" threshold. The probability of cost-effectiveness was 100% across all 10,000 simulations. SMC is a highly cost-effective intervention. Transitioning to a DOT3 strategy is recommended to maximize health and economic impact.</p> Rilwane DJIBRIL, Charles Patrick Makoutode, Lamidhi Salami, Mauricette Makin Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326785 Tue, 16 Jun 2026 00:00:00 +0000 Social marketing and prosocial behavior of the voluntary blood donor: an applied study in the Cameroonian context https://www.ajol.info/index.php/rasp/article/view/326787 <p>Blood transfusion is a critical component of healthcare systems, as it plays a central role in saving lives. However, both globally and in Cameroon, the supply of blood products remains insufficient due to the low rate of voluntary blood donation. In this context, social marketing has emerged as an effective strategic tool for influencing individual behavior and encouraging civic engagement in blood donation. The aim of this study is to examine the influence of social marketing initiatives on the behavior of blood donors and potential donors in Cameroon. A quantitative survey was conducted with a sample of 336 Cameroonian citizens. The analysis relied on a rigorous methodological approach, including exploratory factor analysis, confirmatory factor analysis, and structural equation modeling. Findings indicate that increased use of media channels (particularly television and social networks) by the Ministry of Public Health significantly enhances citizens’ intention and willingness to donate blood. Furthermore, the active promotion of associations involved in blood donation mobilization strengthens potential donors’ civic behavior by reinforcing the perception of blood donation as a socially valuable and responsible act.</p> Emmanuel ESSAMA NANGA, EDZIMBI Roland Elysé , LESSASSY Léopold Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326787 Tue, 16 Jun 2026 00:00:00 +0000 Therapeutic pathways of elderly diabetic patients in Korhogo: Between reasoned action, therapeutic capital, and medical pluralism https://www.ajol.info/index.php/rasp/article/view/326790 <p>This study examines the therapeutic pathways of elderly diabetic patients in Korhogo, Côte d’Ivoire, using a&nbsp;<strong>methods approach</strong>&nbsp;that combines&nbsp;<strong>quantitative surveys (60 structured questionnaires)</strong><strong>&nbsp;</strong>and<strong>&nbsp;</strong><strong>qualitative data (30 semi-structured interviews)</strong><strong>.</strong> The findings reveal complex trajectories shaped by social representations of illness, economic constraints, symbolic affiliations, and the coexistence of biomedical and traditional healing practices. Drawing on the theory of reasoned action and the concept of therapeutic capital, the analysis shows that care decisions are not solely based on accessibility or cost, but stem from a socially situated rationality. Patients alternate between modern medicine and traditional care depending on chronicity, cultural legitimacy, and the relational quality of care. While biomedicine is often associated with technical rigor, endogenous practices are perceived as more accessible, culturally legitimate, and imbued with human proximity. This therapeutic hybridity reflects adaptive strategies in response to aging and structural inequalities. The study advocates for a culturally sensitive integration of both systems, based on therapeutic education, practitioner collaboration, and public policies that acknowledge traditional knowledge. It calls for inclusive, sustainable health models centered on the social realities of aging.</p> Lhaur-Yaigaiba Annette Ouattara Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326790 Tue, 16 Jun 2026 00:00:00 +0000 Systematic review of the performance of pharmaceutical supply chain management https://www.ajol.info/index.php/rasp/article/view/326791 <p>The performance of the pharmaceutical supply chain management system relies on key indicators such as stock-out rates, inventory accuracy, on-time delivery, and final patient satisfaction. The SCOR (Supply Chain Operations Reference) model has emerged as a major tool for identifying critical performance drivers, particularly in resource-limited countries such as Benin. This is a documentary research study conducted using major scientific and institutional databases. The articles were processed using Zotero 5.0.96.3. The search equations were developed using the Population-Intervention-Comparison-Outcomes (PICO) method. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used to ensure transparency and comprehensiveness of the review. The analysis of the results was qualitative. The results showed that: -11 articles were selected; -The SCOR model provides a robust operational framework for identifying critical processes such as planning, procurement, and distribution of essential medicines; - The average on-time delivery rate is 62%, which is below the recommended threshold of 95%; - The order processing cycle ranges from 17 to 32 days, compared to the standard benchmark of 10 days. International and African studies demonstrate that adopting the SCOR model and closely monitoring key performance indicators (KPIs) enhance the resilience, performance, and alignment of the pharmaceutical supply chain with patient needs.</p> Farida Degbey, Charles Patrick Makoutode , Marius Kedote, Géraud Padonou, Yolaine Glele Ahanhanzo Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326791 Tue, 16 Jun 2026 00:00:00 +0000 Community distributors as key players in seasonal malaria chemoprevention in Burkina Faso : recognition, constraints and adaptation strategies https://www.ajol.info/index.php/rasp/article/view/326792 <p><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4105px; top: 87.9037px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.904236);">Seasonal malaria chemoprevention (SMC) relies on community distributors (CD</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 418.408px; top: 87.9037px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.873271);">s), who are key </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4105px; top: 102.649px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.872762);">players in </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 114.857px; top: 102.649px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.925674);">administering</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 175.832px; top: 102.649px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.879653);"> medi</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 202.439px; top: 102.649px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.852909);">cines and raising awareness among </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 368.957px; top: 102.649px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.893367);">the population. However, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4104px; top: 117.283px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.879332);">despite their strategic importance, CDs face multiple organisational, financia</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 414.635px; top: 117.283px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.913789);">l, sociocultural</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 481.598px; top: 117.283px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.918114);">, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4103px; top: 131.917px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.897375);">and security constraints. They also operate in a context of professional precariousnes</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 441.246px; top: 131.917px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.869476);">s, marked </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4103px; top: 146.551px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.898028);">by the absence of official status. These conditions undermine their social legit</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 436.367px; top: 146.551px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.890885);">imacy and </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4103px; top: 161.296px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.911127);">institutional recognition, thereby affecting the quality of intervent</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 369.402px; top: 161.296px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.919882);">ion implementation</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 457.761px; top: 161.296px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.854606);">. This </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.411px; top: 175.93px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.88013);">study examines the role of DCs, focusing on their social and professional recognition, the</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.411px; top: 190.565px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.895974);">constraints they face</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 161.975px; top: 190.565px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.89695);">, and the coping strategies they develop.</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 356.877px; top: 190.565px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.909609);"> We favoured a qualitative </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4111px; top: 205.198px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.8629);">approach using several data collection techniques: direct observation, documentary re</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 453.33px; top: 205.198px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.819271);">search, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4111px; top: 219.833px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.896906);">individual interviews, focus groups</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 224.502px; top: 219.833px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.833949);">, and life stories. Data </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 329.27px; top: 219.833px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.896029);">were</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 350.888px; top: 219.833px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.850742);"> collected from DCs, parents, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4111px; top: 234.577px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.904595);">health workers</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 130.6px; top: 234.577px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.893179);">, and the media before, during</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 262.641px; top: 234.577px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.899456);">, and after the SMC campaigns in Bobo</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 436.588px; top: 234.577px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.91417);">-Dioulasso </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4117px; top: 249.211px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.944706);">over an eight-month period from March to October 2023. A total of 87 individual interviews, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4117px; top: 263.845px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.9203);">eight </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 90.0232px; top: 263.845px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.891091);">focus groups</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 146.564px; top: 263.845px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.899942);">, and four </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 191.132px; top: 263.845px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.894396);">life stories were conducted. The results show that the lack of social </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4114px; top: 278.48px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.912747);">and professional recognition of DCs limits their legitimacy and authority </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 385.815px; top: 278.48px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.92076);">in the community. T</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 474.059px; top: 278.48px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.856533);">he </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4116px; top: 293.225px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.849887);">constraints they face, </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 164.857px; top: 293.225px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.855646);">along with the coping strategies they use daily, reveal significant gaps </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4116px; top: 307.859px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.912844);">between official standards and actual practices in the field, affecting coverage,</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 442.904px; top: 307.859px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.904224);"> parental </span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 65.4116px; top: 322.493px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.855332);">adherence</span><span style="padding: 0px; margin: 0px; color: transparent; position: absolute; white-space: pre; cursor: text; transform-origin: 0% 0%; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; left: 110.201px; top: 322.493px; font-size: 11.0865px; font-family: sans-serif; transform: scaleX(0.911656);">, and the overall effectiveness of the intervention. </span></p> Laurent Gnimian Koudougou Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326792 Tue, 16 Jun 2026 00:00:00 +0000 Determinants of hepatitis B vaccination among newborns in Benin in 2023 https://www.ajol.info/index.php/rasp/article/view/326846 <p>Hepatitis B infection remains a major public health concern. Disparities persist in birth-dose vaccination coverage in Bohicon, Benin. This study aimed to identify the determinants of hepatitis B vaccination coverage in this commune in 2023. This was a cross-sectional study with retrospective data collection, using a mixed-methods approach, conducted in 2024 among newborns, their mothers, and healthcare workers responsible for vaccination. Newborns were selected using three-stage cluster sampling. Data were collected using a structured questionnaire administered to mothers, a data extraction form for health records and vaccination registers, and an interview guide for vaccination healthcare providers. Data analysis was performed using Stata 15. Bivariate analysis was followed by multivariate analysis. Variables retained in the final model were those with a p-value &lt; 5%. A total of 340 newborns and their mothers were surveyed. Hepatitis B vaccination coverage was 77.06%. Determinants of vaccination were place of delivery, specifically in a public health centre (OR=10.38; 95%CI=[4.37; 24.65]) or a private centre (OR=3.51; 95%CI=[1.36; 9.05]); a favourable family perception of vaccination (OR=5.23; 95%CI=[2.68; 10.21]); normal birth weight (OR=21.26; 95%CI=[6.67; 67.72]) or birth weight &gt; 4000 grammes (OR=130.83; 95%CI=[10.55; 162.12]); and the absence of neonatal resuscitation at birth (OR=7.34; 95%CI=[2.24; 23.96]). Overall, vaccination remains a challenge in the municipality of Bohicon.</p> Vignon Dègbédji Bedie, Lamidhi SALAMI, Elisée D. Houngbo, Marius Nonvignon Kedote, Charles-Patrick Makoutode Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326846 Tue, 16 Jun 2026 00:00:00 +0000 Comparative study of malaria prevalence in the health districts of Kayes and Sélingué from 2018 to 2022 https://www.ajol.info/index.php/rasp/article/view/326922 <p>In Mali, malaria transmission is heterogeneous due to the diversity of eco-climatic zones and the complexity of the vector system. This study aimed to compare malaria prevalence in the health districts of Kayes and Sélingué from 2018 to 2022. This was a cross-sectional study analyzing District Health Information Software-2 data from 2018 to 2022. All complete records were considered and analyzed using R software, and comparisons were made using StatsTester_4.0.1. The significance threshold was 5%. Anonymity and confidentiality were<br>respected. Children under 5 years of age were the most represented in both health districts. The annual prevalence of malaria was statistically higher in the Sélingué health district than in Kayes in 2018 (10.6% vs. 3.9%; p=0.001), 2019 (10.4% vs. 4.7%; p=0.001), 2020 (9.6% vs. 3.4%; p=0.001), 2021 (7.5% vs. 3.2%; p=0.001), and 2022 (12.1% vs. 3.5%; p=0.001). Rapid diagnostic testing was the most commonly used diagnostic method in both districts (94.72% in Kayes and 94.06% in Sélingué). The third quarter was the period of high disease transmission in both districts. Our results showed high malaria transmission in Sélingué compared to Kayes. The national diagnostic policy is being followed in both districts with the use of rapid diagnostic tests. Further research is needed to explore the factors influencing malaria transmission and to better tailor interventions.</p> Oumar Sangho, Ousmane Boua TOGOLA, Binta DEM, Borodjan DIARRA, Fanta SANGHO Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326922 Tue, 16 Jun 2026 00:00:00 +0000 Modeling the impact of health interventions on mortality among children under five years with Lives Saved Tool (LiST) inMali https://www.ajol.info/index.php/rasp/article/view/326923 <p>The mortality of children under five in low-income countries remains a public health problem. The objective was to study the impact of the change in coverage of interventions in maternal, neonatal and child health and nutrition from 2001 to 2018 on the mortality of children under five. on under-5 mortality in Mali. It was an evaluative modelled using the Lives Saved Tool (LiST) version 6.8 Beta. The interventions selected were those defined in the various strategic plans between 2001 – 2018 relating to maternal and child health. The results showed that the under-five mortality rate decreased from 229 to 135 per thousand live births between 2001 and 2018. The interventions that saved the most lives were the measles vaccine (724 lives saved),&nbsp;the management of chronic malnutrition (467 lives saved),&nbsp;possession&nbsp;of mosquito nets impregnated with insecticide against malaria (428 lives saved),&nbsp;treatment of malaria with Artemisinin-based Combination Therapy (282 lives saved),&nbsp;and antibiotics against pneumococcus (261 lives saved). The evaluation revealed that the coverage levels of the interventions of the plans in force have reduced the mortality rates, but target 4 of the Millennium Development Goals has not been achieved.<strong>&nbsp;</strong></p> Niakale DIAWARA, Nouhoum Telly, Abdoulaye Ouologuem, Mariam Traoré, Hamadoun Sangho Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326923 Tue, 16 Jun 2026 00:00:00 +0000 Factors associated with non-adherence to antiretroviral treatment among people living with HIV followed in health centers in the Oubri region, Burkina Faso https://www.ajol.info/index.php/rasp/article/view/326971 <p>The WHO’s “test and treat” strategy has helped increase the number of people living with HIV (PLHIV)&nbsp; on&nbsp; antiretroviral&nbsp; therapy.&nbsp; However,&nbsp; the&nbsp; goal&nbsp; of&nbsp; viral&nbsp; suppression&nbsp; remains&nbsp; far from being&nbsp; achieved.&nbsp; Adherence,&nbsp; one&nbsp; of&nbsp; the&nbsp; key&nbsp; factors&nbsp; in&nbsp; achieving&nbsp; viral&nbsp; suppression,&nbsp; remains a challenge. The objective of our study was to identify factors associated with non-adherence to antiretroviral therapy in Burkina Faso’s Oubri region. An analytical study was conducted from June to December 2025. PLHIV aged 18 and older were interviewed upon arrival for their follow-up visits. Adherence was assessed based on self-reported medication intake. Individuals who had missed at least one day of treatment in the month preceding the survey were considered non-adherent. A logistic regression analysis was performed to identify the associated factors. A total of 328 participants were included: 232 women (70.73%) and 96 men (29.27%). The mean age was 45.89 ± 12.04 years. Sixty-five participants (19.82% ;&nbsp; 95% CI: 15.77–24.40) were non-adherent. Factors independently associated with non-adherence were difficulty accessing health facilities&nbsp; due&nbsp; to&nbsp; distance&nbsp; (aOR&nbsp; =&nbsp; 4.23&nbsp; [95%&nbsp; CI:&nbsp; 2.24–8.00])&nbsp; and&nbsp; perceived&nbsp; severity&nbsp; of&nbsp; HIV-related&nbsp; illness&nbsp; (aOR&nbsp; =&nbsp; 1.97&nbsp; [95%&nbsp; CI:&nbsp; 1.10–3.56]).&nbsp; Community-based strategies&nbsp; to&nbsp; support &nbsp;adherence, as well as psychological counseling, should be strengthened.</p> Wedminere Noelie Zoungrana Yameogo, Smaila Ouedraogo, Fidèle Bakiono, Toussaint Tapsoba, Koine Maxime Drabo Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326971 Tue, 16 Jun 2026 00:00:00 +0000 Evaluation of knowledge and practice on hygienic and dietary measures in type 2 diabetics at the Mali hospital in 2024 https://www.ajol.info/index.php/rasp/article/view/326973 <p>Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin or the body does not properly use the insulin produced. It represents a major public health issue, particularly in Mali, where more than 2 million people are affected by it. In a context marked by&nbsp; poverty&nbsp; and&nbsp; low&nbsp; levels&nbsp; of&nbsp; education,&nbsp; the&nbsp; application&nbsp; of&nbsp; health&nbsp; and&nbsp; diet&nbsp; measures&nbsp; (MHD), &nbsp;although&nbsp; essential&nbsp; in&nbsp; the&nbsp; management&nbsp; of&nbsp; diabetes,&nbsp; remains&nbsp; difficult.&nbsp; This&nbsp; study aimed&nbsp; to evaluate the level of knowledge and practices of persons with type 2 diabetes (T2D) on health and&nbsp; diet&nbsp; measures. &nbsp;A&nbsp; cross-sectional&nbsp; study&nbsp; was&nbsp; conducted&nbsp; from&nbsp; August&nbsp; to&nbsp; October&nbsp; 2023, &nbsp;involving 205 patients followed for T2D at the Mali hospital. Data were collected through face-to-face interviews&nbsp; with&nbsp; patients&nbsp; and&nbsp; a&nbsp; review&nbsp; of&nbsp; their&nbsp; medical&nbsp; records.&nbsp; The&nbsp; analysis&nbsp; was &nbsp;performed using SPSS-20 software. Approximately 48.8% of patients with T2DM (PDT2) had good knowledge of the definition of diabetes, and 8.8% knew the type of diabetes they had. The most cited sign was the frequent urge to urinate (92.2% of PDT2). In terms of practice, 38% of the participants performed regular blood sugar monitoring at home, 29.3% consulted a dietitian,and 43.9% practiced physical activity. The most common difficulty in respecting the MHD was financial&nbsp; (59.5&nbsp; %).&nbsp; Our&nbsp; study&nbsp; revealed&nbsp; that,&nbsp; despite&nbsp; MHDs&nbsp; having&nbsp; good knowledge,&nbsp; their practice was limited. An analytical study could better identify these factors.</p> Oumar Sangho, Mory BENGALY, Ahamed Mohamed TRAORE, Salia KEITA, Issa COULIBALY Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326973 Tue, 16 Jun 2026 00:00:00 +0000 Factors associated with incomplete prenatal care: A multilevel comparative analysis of data from the demographic and health surveys of Burkina Faso and Mali https://www.ajol.info/index.php/rasp/article/view/326977 <p>Prenatal care (PNC) constitutes a platform for providing important health services, including health&nbsp; promotion,&nbsp; screening,&nbsp; diagnosis,&nbsp; and&nbsp; disease&nbsp; prevention.&nbsp; It&nbsp; serves&nbsp; to&nbsp; identify&nbsp; risks, &nbsp;prevent, and manage pathologies related to or discovered during pregnancy. The objective of this&nbsp; study&nbsp; is&nbsp; to&nbsp; determine,&nbsp; beyond&nbsp; individual&nbsp; characteristics,&nbsp; the&nbsp; contextual&nbsp; factors&nbsp; that &nbsp;influence the completeness of prenatal care, while conducting a comparative analysis of these factors in two neighboring countries sharing a similar sociocultural and politico-health context. The&nbsp; multilevel&nbsp; logistic&nbsp; regression&nbsp; model&nbsp; was&nbsp; used&nbsp; to&nbsp; determine&nbsp; the&nbsp; factors&nbsp; associated&nbsp; with &nbsp;incomplete PNC in both countries. The prevalence of incomplete PNC was 26.69% for Burkina Faso and 42.99% for Mali. Respectively, 14.51% and 20.50% of the variation in incomplete prenatal care among women is attributable to enumeration areas. After adjustment, the analysis showed&nbsp; a&nbsp; significant&nbsp; decrease&nbsp; in&nbsp; the&nbsp; risk&nbsp; of&nbsp; incomplete&nbsp; prenatal&nbsp; care&nbsp; (PNC)&nbsp; when,&nbsp; in&nbsp; both &nbsp;countries, women were between 25 and 49 years old, their partners had a secondary education or&nbsp; higher,&nbsp; they&nbsp; were&nbsp; wealthy,&nbsp; and&nbsp; distance&nbsp; from&nbsp; a&nbsp; health&nbsp; center&nbsp; was&nbsp; a&nbsp; problem.&nbsp; This&nbsp; study &nbsp;concludes that there are common factors in both countries that influence the completeness of PNC. Therefore, it is important to combat poverty, promote education, and reduce inequalities in health coverage to improve women's access to PNC.</p> COMPAORE Augustin, Aristide Romaric Bado Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326977 Tue, 16 Jun 2026 00:00:00 +0000 Elder abuse of people over 60 years of age: a phenomenon still neglected by public policy in Africa. A narrative review and anthropological approach https://www.ajol.info/index.php/rasp/article/view/326985 <p>Elder abuse is a universal phenomenon. Interventions are developed and implemented worldwide, but they are poorly understood and rarely evaluated. The objective of this review is to assess the state of the literature on interventions to combat elder abuse in African countries and to explain the relative scarcity of published studies. The review identified 41 publications in French and English extracted from&nbsp; several&nbsp; databases,&nbsp; including&nbsp; Medline,&nbsp; AgeLine,&nbsp; Health&nbsp; Policy&nbsp; Reference&nbsp; Centre,&nbsp; CINAHL &nbsp;Complete,&nbsp; ERIC,&nbsp; Political&nbsp; Science&nbsp; Complete,&nbsp; and&nbsp; the&nbsp; Psychology&nbsp; and&nbsp; Behavioural&nbsp; Sciences Collection.&nbsp;&nbsp; Knowledge&nbsp;&nbsp; about&nbsp;&nbsp; elder&nbsp;&nbsp; abuse&nbsp;&nbsp; is&nbsp;&nbsp; limited,&nbsp;&nbsp; fragmented,&nbsp;&nbsp; and&nbsp;&nbsp; unevenly&nbsp;&nbsp; distributed&nbsp; &nbsp;geographically&nbsp; and&nbsp; linguistically.&nbsp; The&nbsp; findings&nbsp; suggest&nbsp; that&nbsp; interventions&nbsp; aimed&nbsp; at&nbsp; combating&nbsp; elder &nbsp;abuse are ignored and overlooked on the African agenda.</p> GEORGE ROUAMBA, Christelle S. Liliane KAFANDO, Marie-Madeleine SIMBRENI Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0 https://www.ajol.info/index.php/rasp/article/view/326985 Tue, 16 Jun 2026 00:00:00 +0000