Références bibliographiques

Meyer Jean-Baptiste, Benguerna M., Pellegrini C., Alazali M. et Benbouzid K. (2023) « Higher education in North Africa: comparative evolution of Algeria and Morocco », The Journal of North African Studies, 28 (1) (janvier 2), p. 100-117. DOI : 10.1080/13629387.2022.2028259. https://www.tandfonline.com/doi/full/10.1080/13629387.2022.2028259.

Mezin Laetitia, Rousseau Anne, Sellier Yann, Teixeira Luis et Schantz Clémence (2023) « « Un vaccin qui reste quand même à part » : Papillomavirus et vaccination en France », Santé Publique, 35 (2), p. 127-137. DOI : 10.3917/spub.232.0127. https://www.cairn.info/revue-sante-publique-2023-2-page-127.htm.

Résumé : Introduction : La vaccination contre le papillomavirus humain (HPV) est aujourd’hui peu répandue en France où le taux vaccinal est l’un des plus faibles d’Europe. Pourtant, ce virus est rencontré par 80 % de la population et entraine 3 000 nouveaux cas de cancers du col de l’utérus par an. Cette vaccination constitue un réel levier d’action, notamment par le biais des médecins généralistes. But de l’étude : L’objectif était de comprendre le faible taux vaccinal en France et de proposer des solutions durables pour augmenter l’adhésion à ce vaccin. Avec une approche qualitative, nous avons documenté les perceptions, réticences et obstacles de seize médecins généralistes en Île de France. Résultats : Le vaccin anti-HPV présente des particularités qui rendent son abord plus délicat auprès de la population. D’abord, parce qu’il touche à l’intimité des patients et ce, dès un très jeune âge. Ensuite, parce qu’il a longtemps été dédié à un public féminin ; l’ouverture de la vaccination aux garçons du même âge entraine donc une modification des discours et une rupture avec son image genrée. Enfin, cette vaccination s’inscrit dans un contexte où l’hésitation vaccinale est marquée en France, avec une circulation rapide d’informations plus ou moins fiables venant souvent mettre en difficulté le corps médical. Conclusions : Les professionnels de santé détiennent un rôle clé pour convaincre et entrainer l’adhésion des patients, et une majorité des médecins reste favorable à cette vaccination. S’appuyer sur un ensemble de professionnels de santé plus large pourrait permettre d’augmenter l’adhésion vaccinale en France.

Mots-clés : Cancer, HPV, Information, Médecins Généralistes, Vaccin, ⚠️ Invalid DOI.

Miani Céline, Batram-Zantvoort Stephanie, Pitchforth Emma, Treadgold Bethan, Johnston Krista, Rozée Virginie, McDouglas Christiana, Schantz Clémence et van Teijlingen, Edwin (2023) « Out-of-hospital births: A small but growing phenomenon in high income countries: A viewpoint », Journal of Asian Midwives (JAM), 10 (2), p. 77-78.

Mots-clés : ⛔ No DOI found.

Mladovsky Philipa, Prince Ruth, Hane Fatoumata et Ridde Valéry (2023) « The primacy of politics in neoliberal universal health coverage policy reform. A commentary on ‘financing and provision of healthcare for two billion people in low-income nations: Is the cooperative healthcare model a solution?” by William C Hsiao and Winnie Yip », Social science & medicine, p. 115742. DOI : 10.1016/j.socscimed.2023.115742. https://hal.science/hal-04147860.

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PubMed entry

Nédélec Elise (2023) « Cancers féminins en Côte d'Ivoire : une anthropologie des trajectoires de soin et de la prise en charge biomédicale à Abidjan », Thèse de doctorat en anthropologie, Bordeaux : Université de Bordeaux.

Résumé : Les récents rapports de l’OMS indiquent que 70% des nouveaux cas de cancers se situent dans les pays des Suds (dits à revenus faibles ou intermédiaires), chiffre prévu en augmentation durant la prochaine décennie. Pourtant, dans de nombreuses régions du monde, on assiste au silence des pouvoirs publics, des institutions de santé, des médias et aussi, parfois, de la société civile, face au cancer. Á Abidjan, en Côte d’Ivoire, cette maladie touche des milliers de personnes selon les dernières estimations du Registre des cancers d’Abidjan. Elle devient une question de santé publique bien qu’encore négligée. Le triptyque VIH – tuberculose – paludisme domine l’action sanitaire et sociale à l’échelle nationale. Néanmoins, une équipe de soignants s’est progressivement spécialisée dans la prise en charge thérapeutique des personnes atteintes d’un cancer. Depuis les années 1980, ces professionnels de santé (essentiellement des médecins et quelques infirmiers) forment l’unique service de cancérologie en Côte d’Ivoire, au sein d’un Centre Hospitalier Universitaire (CHU) d’Abidjan. En l’absence de radiothérapie, la réalisation d’interventions chirurgicales et de chimiothérapies constitue le plateau technique disponible. Seulement, ces soins sont extrêmement couteux et trop souvent à la charge des malades et de leurs familles (en dehors de ceux, minoritaires, disposant d’assurances privées ou d’Etat). Cette thèse s’intéresse particulièrement aux expériences de femmes atteintes d’un cancer du sein ou du col de l’utérus et des soignants qui sont impliqués dans la prise en charge de ces maladies. Ces deux organes étant les plus concernés par la maladie cancéreuse en Côte d’Ivoire, les femmes représentent la population la plus touchée. Par l’approche compréhensive que permet l’anthropologie, cette recherche propose d’étudier les dimensions expérientielles, socio-culturelles et quotidiennes des femmes affectées et des équipes médicales de cancérologie et de gynécologie engagées. Il s’agit de mettre en exergue leurs vécus et leurs représentations de ces expériences ainsi que les relations de soins, en tenant compte des subjectivités de chacun (soignant / soignée). Pour cela, les techniques d’enquête employées sont les méthodes ethnographiques. La réalisation d’observations (en contexte hospitalier et en dehors, dans l’intimité des foyers), la conduite d’entretiens semi-directifs et libres (récits de vie), comme la tenue de focus group permettent de recueillir des données au plus proche des expériences des acteurs.

Nuampa Sasitara, Ratinthorn Ameporn, Lumbiganon Pisake, Rungreangkulkij Somporn, Rujiraprasert Nilubon, Buaboon Natthapat, Jampathong Nampet, Dumont Alexandre, Hanson Claudia, Loenzien Myriam de, Bohren Meghan A. et Betrán Ana Pilar (2023) « Because it eases my Childbirth Plan: a qualitative study on factors contributing to preferences for caesarean section in Thailand », BMC Pregnancy and Childbirth, 23 (1) (avril 24), p. 280. DOI : 10.1186/s12884-023-05576-8. https://hal.science/hal-04149594.

Résumé : BACKGROUND: Although caesarean section (CS) rates have increased rapidly in Thailand, the upward trend is not supported by significant maternal or perinatal health benefits. The appropriate use of CS through QUALIty DECision-making by women and providers (QUALI-DEC project) aims to design and implement a strategy to optimize the use of CS through non-clinical interventions. This study aimed to explore the factors influencing women’s and health professionals’ preferences for CS delivery in Thailand. METHODS: We conducted a formative qualitative study by using semi-structured in-depth interviews with pregnant and postpartum women, and healthcare staff. Purposive sampling was used to recruit participants from eight hospitals across four regions of Thailand. Content analysis was used to develop the main themes. RESULTS: There were 78 participants, including 27 pregnant and 25 postpartum women, 8 administrators, 13 obstetricians, and 5 interns. We identified three main themes and seven sub-themes of women and healthcare providers’ perceptions on CS: (1) avoiding the negative experiences from vaginal birth (the pain of labor and childbirth, uncertainty during the labor period); (2) CS is a safer mode of birth (guarantees the baby’s safety, a protective shield for doctors); and (3) CS facilitates time management (baby’s destiny at an auspicious time, family’s management, manage my work/time). CONCLUSIONS: Women mentioned negative experiences and beliefs about vaginal delivery, labor pain, and uncertain delivery outcomes as important factors influencing CS preferences. On the other hand, CS is safer for babies and facilitates multiple tasks in women’s lives. From health professionals’ perspectives, CS is the easier and safer method for patients and them. Interventions to reduce unnecessary CS, including QUALI-DEC, should be designed and implemented, taking into consideration the perceptions of both women and healthcare providers.

PubMed entry

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Oliveira S. R., Cazarin G., Sampaio A. S., Vasconcelos A. L. de, Furtado B., Medeiros S. G. de, Zacarias A. C., Andrade A. C., Sousa K. M. de, Zinszer K. et Ridde Valéry (2023) « Potential strengths and weaknesses in hospital resilience in the context of the COVID-19 pandemic in Brazil : a case study », Health Systems & Reform, 9 (2), p. 2177242 [10 p.]. DOI : 10.1080/23288604.2023.2177242. https://hal.science/hal-04145231.

Résumé : T

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Oraisón Mercedes et Mick Carola (2023) « Expériences participatives en perspective décoloniale. Possibilités et limites » (présenté à Ccerbal 2023 - séance précolloque), in Plurilinguismes et migration et en internationalisation: conversations sur le lien entre la recherche et l'action publique, Ottawa, Canada (mode hybride). https://ccerbal2023.sciencesconf.org/data/pages/Horaire_provisoire_Tentative_Schedule_2_CCERBAL_2027.pdf.

Pérouse de Montclos Marc-Antoine (2023) « Les États et la paysannerie de l'Afrique sahélienne au défi du djihad et du banditisme rural », Questions internationales, 115, p. 78. https://hal.science/hal-04143968.

Résumé : Au Sahel et dans la Corne de l'Afrique, la menace terroriste et jihadiste retient généralement toute l'attention des milieux sécuritaires. Mais la diffusion de la violence sur le continent résulte aussi du banditisme rural et de la défaillance des Etats, avec des variations importantes d'une région à l'autre.

Mots-clés : ⛔ No DOI found.

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Petitfour L., Bonnet Emmanuel, Mathevet I., Nikiema A. et Ridde Valéry (2023) « Paiements directs et dépenses catastrophiques liés aux accidents de la route à Ouagadougou, Burkina Faso », Ed. Science et Bien Commun. https://hal.science/hal-04130129.

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Plazy Mélanie, Becquet Valentine, Maouhoub Esther, Meertens Carla, Mouquin Remi, Youssoufa Hasna, Nouaman Marcellin N., Coffie Patrick et Larmarange Joseph (2023) « PrEP among female sex workers: where are we? A literature review identifying knowledge gaps to guide the future research agenda » (communication orale), présenté à AIDS Impact Conference, Stockholm. https://hal.science/hal-04120001.

Résumé : Objectives. In 2015, the WHO recommended HIV pre-exposure prophylaxis (PrEP) for people at substantial risk of being infected by HIV, but also highlighted the need for research projects to improve PrEP implementation and follow-up, especially among female sex workers (FSW). While many studies have been published on PrEP among men who have sex with men, the literature is far less important among FSW. We aim to summarise the overall published literature on PrEP among FSW worldwide to display the challenges and facilitators of PrEP implementation in this population and highlight the knowledge gaps. Methods. We have conducted a systematic literature review searching Pubmed, Web of Sciences, Scopus, SocINDEX, APA PsycArticles, APA PsycInfo, Psychology and Behavioral Sciences Collection, until 31 December 2022. All manuscripts on PrEP in FSW were included worldwide, regardless of the primary outcome, the type of PrEP (oral, topical or long-acting), the study design, or the type of data collection. Titles and abstracts were independently screened by three reviewers, and full texts by two reviewers. We excluded papers: not presenting specific or stratified results on FSW; study protocols; conference abstracts; not written in English or French. Two independent reviewers then reviewed each included study to extract: Unaids region, country, study type, outcomes (see description in the results), type of PrEP, and study years. The results of the included papers will be analysed in more detail by one reviewer for each type of outcome. Results. Among the 412 published references identified through the search equation after duplicate removal, 198 were excluded based on the title and abstract, and 69 were excluded after full-text reading. Among the 145 papers included, n=10 were commentaries, n=17 literature reviews on global HIV prevention or including several populations, n=3 country case studies, n=24 modelling studies and n=91 other original papers. Among the latest, n=51 studies were conducted in Eastern and Southern Africa, n=13 in Western and Central Africa, n=11 in Asia and the Pacific, n=9 in Western and Central Europe and North America, n=7 in Latin America and the Caribbean; no studies were conducted in the Middle East and North Africa or Eastern Europe and Central Asia. The majority (n=85) were about oral PrEP. Regarding outcomes, n=39 were on knowledge/awareness, n=42 on willingness/interest, n=38 on attitudes/perceptions/beliefs, n=42 on uptake/use, n=21 on retention, n=23 on adherence, n=4 on efficacy/effectiveness, n=3 on epidemiological impacts, n=18 on behavioural impacts, n=5 on social impacts, n=10 on delivery models, n=9 on costs. Specific results for each type of outcome is in progress. Preliminary results suggest high PrEP willingness among FSW, but specific challenges regarding oral PrEP uptake and retention in this population. Discussion. The overall literature on PrEP focusing on FSW is relatively scarce (compared to more than 1850 references on PrEP among men who have sex with men identified on Pubmed by the end of 2022). The final results of this literature review will be available by May 2023. They will allow to guide the future research agenda regarding the implementation of biomedical HIV prevention among FSW.

Plazy Mélanie, Diallo Adama, Hlabisa Thabile, Okesola Nonhlanhla, Iwuji Collins, Herbst Kobus, Boyer Sylvie, Lert France, McGrath Nuala, Pillay Deenan, Dabis François, Larmarange Joseph, Orne-Gliemann Joanna et for the ANRS TasP Study Group (2023) « Implementation and effectiveness of a linkage to HIV care intervention in rural South Africa (ANRS 12249 TasP trial) », PLOS ONE, 18 (1) (janvier 20), p. e0280479. DOI : 10.1371/journal.pone.0280479. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0280479.

Résumé : Background Timely linkage to care and ART initiation is critical to decrease the risks of HIV-related morbidity, mortality and HIV transmission, but is often challenging. We report on the implementation and effectiveness of a linkage-to-care intervention in rural KwaZulu-Natal, South Africa. Methods In the ANRS 12249 TasP trial on Universal Testing and Treatment (UTT) implemented between 2012–2016, resident individuals ≥16 years were offered home-based HIV testing every six months. Those ascertained to be HIV-positive were referred to trial clinics. Starting May 2013, a linkage-to-care intervention was implemented in both trial arms, consisting of tracking through phone calls and/or home visits to “re-refer” people who had not linked to care to trial clinics within three months of the first home-based referral. Fidelity in implementing the planned intervention was described using Kaplan-Meier estimation to compute conditional probabilities of being tracked and of being re-referred by the linkage-to-care team. Effect of the intervention on time to linkage-to-care was analysed using a Cox regression model censored for death, migration, and end of data follow-up. Results Among the 2,837 individuals (73.7% female) included in the analysis, 904 (32%) were tracked at least once, and 573 of them (63.4%) were re-referred. Probabilities of being re-referred was 17% within six months of first referral and 31% within twelve months. Compared to individuals not re-referred by the intervention, linkage-to-care was significantly higher among those with at least one re-referral through phone call (adjusted hazard ratio [aHR] = 1.82; 95% confidence interval [95% CI] = 1.47–2.25), and among those with re-referral through both phone call and home visit (aHR = 3.94; 95% CI = 2.07–7.48). Conclusions Phone calls and home visits following HIV testing were challenging to implement, but appeared effective in improving linkage-to-care amongst those receiving the intervention. Such patient-centred strategies should be part of UTT programs to achieve the UNAIDS 95-95-95 targets.

Mots-clés : Antiretroviral therapy, Educational attainment, HIV, HIV diagnosis and management, HIV epidemiology, Schools, Viral load, Virus testing.

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Pourette Dolorès (2023) « Réorganiser la distribution des médicaments antirétroviraux pour les personnes vivant avec le VIH à Antananarivo (1ère vague de l’épidémie de Covid-19) : enjeux de mobilité et de confidentialité » (Communication orale), présenté à L’océan Indien traversé par l’épidémie de COVID-19, colloque organisé par l'OPPEE et le LCF, Université de La Réunion, Saint-Denis.

Pourette Dolorès, Rakotoarisoa Onintsoa, Nandrasana Rakotomanana Elliot Fara et Mattern Chiarella (2023) « Maintenir le traitement antirétroviral lors de la première vague de l’épidémie de Covid-19 à Antananarivo : réorganisation des services, travail de care et mobilités des médicaments et des acteurs et actrices du VIH », Anthropologie & Santé. Revue internationale francophone d'anthropologie de la santé, 26 (avril 12). DOI : 10.4000/anthropologiesante.12686. https://journals.openedition.org/anthropologiesante/12686.

Résumé : À Antananarivo, lors de la première vague de la pandémie de Covid-19, les modes et les lieux de distribution des médicaments antirétroviraux ont dû être réorganisés afin de maintenir le traitement médical des personnes vivant avec le VIH (PvVIH). Ce texte s’appuie sur une étude par entretiens semi-directifs réalisée auprès d’acteurs et actrices du VIH (PvVIH, professionnel·le·s de santé, acteur·rice·s associatif·ve·s) entre janvier et juillet 2021. Alors que l’une des structures de soins enquêtées a réaménagé un espace dans l’enceinte de l’hôpital pour y délivrer les médicaments, d’autres structures ont délocalisé leur distribution à l’extérieur, au plus près des PvVIH. Ces réorganisations ont été guidées par le souci du maintien de la confidentialité et ont affecté les mobilités des personnes et des molécules. L’article met en lumière les compétences spatiales et sociales des patient·e·s ainsi que le rôle des médiateurs et médiatrices associatif·ive·s et l’importance du lien téléphonique comme support de care dans un contexte de distance géographique entre patient·e·s, soignant·e·s et acteur·rice·s associatif·ve·s.

Mots-clés : Covid-19, Madagascar, médicaments antirétroviraux, mobilités, structures de soins, VIH.

Rahm Laura, De Zordo Silvia, Mishtal Joanna, Zanini Giulia, Garnsey Camille, Clougher Derek et Gerdts Caitlin (2023) « French women’s experiences and opinions with in-country versus cross-border abortion travel: a mixed-methods paper », BMJ Sexual & Reproductive Health (janvier 24), p. bmjsrh-2022-201712. DOI : 10.1136/bmjsrh-2022-201712. http://jfprhc.bmj.com/content/early/2023/01/23/bmjsrh-2022-201712.abstract.

Résumé : Objectives This is the first study contrasting the experience of women residing in France and travelling for abortion services inside and outside their country of residence. We compare travel reasons and costs as well as our study participants’ opinions of abortion legislation. The article documents legal and procedural barriers related to accessing local and timely abortions and provides policy recommendations to broaden care options.Methods The study is based on a mixed-methods research design. Quantitative data were descriptively analysed using Stata and drawn from 100 surveys with in-country abortion seekers collected from 3 Parisian hospitals, and 57 surveys with French residents seeking abortion care in the Netherlands (42), Spain (10) and the UK (5). Qualitative data were thematically analysed using ATLAS.ti and drawn from 36 interviews with French residents (23 in-country abortion seekers and 13 cross-border abortion travellers).Findings Gestational age (GA) limits were the key reason for cross-border travel, while lack of close-by, timely and good quality abortion care was the main driver for in-country abortion travel. Unlike in-country travellers, cross-border abortion seekers faced significant financial costs and burdens related to such travel. Partners, family members and service providers offered important support structures to both cross-border and in-country travellers.Conclusions Legal time limits appeared to be the key driver for abortion-related travel of French residents. Having passed or being at risk of exceeding the GA limit caused women to travel outside their country or department of residence for abortion care.All data relevant to the study are included in the article or uploaded as supplementary information.

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PubMed entry

Ravalihasy Andrainolo, Ante-Testard Pearl Anne, Kardas-Sloma Lidia, Yazdanpanah Yazdan, De Allegri Manuela et Ridde Valéry (2023) « Quantitative Methods Used to Evaluate Impact of Combination HIV Prevention Intervention: A Methodological Systematic Review », AIDS and Behavior (janvier 27). DOI : 10.1007/s10461-023-04000-8. https://doi.org/10.1007/s10461-023-04000-8.

Résumé : Combination HIV prevention aims to provide the right mix of biomedical, behavioral and structural interventions, and is considered the best approach to curb the HIV pandemic. The impact evaluation of combined HIV prevention intervention (CHPI) provides critical information for decision making. We conducted a systematic review of the literature to map the designs and methods used in these studies. We searched original articles indexed in Web of Science, Scopus and PubMed. Fifty-eight studies assessing the impact of CHPI on HIV transmission were included. Most of the studies took place in Asia or sub-Saharan Africa and were published from 2000 onward. We identified 36 (62.1%) quasi-experimental studies (posttest, pretest–posttest and nonequivalent group designs) and 22 (37.9%) experimental studies (randomized designs). The findings suggest that diverse methods are already rooted in CHPI impact evaluation practices as recommended but should be better reported. CHPI impact evaluation would benefit from more comprehensive approaches.

Mots-clés : Combination HIV prevention intervention, Decision-making, Evidence-based, Impact evaluation.

Ravit Marion, Lohmann Julia, Dumont Alexandre, Kabore Charles, Koulidiati Jean‐Louis et De Allegri Manuela (2023) « How a supply‐side intervention can help to increase caesarean section rates in Burkina Faso facilities—Evidence from an interrupted time‐series analysis using routine health data », Tropical Medicine & International Health, 28 (2), p. 136-143. DOI : 10.1111/tmi.13840. https://onlinelibrary.wiley.com/doi/10.1111/tmi.13840.

Richard Zoé, Chabrol Fanny, Gautier Lara, Zinszer Kate et Ridde Valéry (2023) « Considering social inequalities in health in COVID-19 response: insights from a French case study », Health Promotion International, 38 (1) (février 1), p. daac173. DOI : 10.1093/heapro/daac173. https://doi.org/10.1093/heapro/daac173.

Résumé : The COVID-19 pandemic highlighted the impact of social inequalities in health (SIH). Various studies have shown significant inequalities in mortality and morbidity associated with COVID-19 and the influence of social determinants of health. The objective of this qualitative case study was to analyze the consideration of SIH in the design of two key COVID-19 prevention and control interventions in France: testing and contact tracing. Interviews were conducted with 36 key informants involved in the design of the intervention and/or the government response to the pandemic as well as relevant documents (n = 15) were reviewed. We applied data triangulation and a hybrid deductive and inductive analysis to analyze the data. Findings revealed the divergent understandings and perspectives about SIH, as well as the challenges associated with consideration for these at the beginning stages of the pandemic. Despite a shared concern for SIH between the participants, an epidemiological frame of reference dominated the design of the intervention. It resulted in a model in which consideration for SIH appeared as a complement, with a clinical goal of the intervention: breaking the chain of COVID-19 transmission. Although the COVID-19 health crisis highlighted the importance of SIH, it did not appear to be an opportunity to further their consideration in response efforts. This article provides original insights into consideration for SIH in the design of testing and contact-tracing interventions based upon a qualitative investigation.The COVID-19 pandemic has highlighted the importance of social inequalities in health (SIH) and the disproportionate burden of the pandemic and its consequences related to socioeconomic status, ethnicity and race, among other determinants of health. Public health interventions are likely to increase SIH when they are not considered in the design phase. Through a qualitative case study, we analyzed the design of one of the first local initiative providing testing and contact tracing offer to the general population in the Île-de-France region (Paris region, France) in response to the COVID-19 pandemic. This article discusses the uncertainty and challenges associated with consideration for SIH in the intervention design. It explores the diverse understandings of SIH among the actors and the complexities of cross-sectoral partnerships addressing SIH in times of health crisis. Despite a consensual concern for this issue among the respondents, an epidemiological frame of reference dominated the intervention design. It resulted in a model in which consideration for SIH appeared as a complement, with a clinical goal of the intervention: breaking the chain of COVID-19 transmission.

Ridde V., Carillon S., Loû A. Desgrées Du et Sombié I. (2023) « Analyse de la mise en œuvre des interventions de santé publique : besoin de rigueur et défis de la participation des parties prenantes », Epidemiology and Public Health = Revue d'Epidémiologie et de Santé Publique, 71 (2), p. TT. DOI : 10.1016/j.respe.2022.06.001. https://hal.science/hal-04149573.

Résumé : OBJECTIVES: This article shows how conceptual models can help to develop and evaluate public health interventions. It also reports on the challenges of getting stakeholders involved. METHOD: The analysis is based on the reflexive approach applied by the authors during their participation in two public health intervention research (PHIR) projects, in France and in Burkina Faso. RESULTS: In Paris, PHIR aimed to enable sub-Saharan immigrants to appropriate the existing means of prevention and sexual health care and to strengthen their empowerment in view of preserving their health. Evaluation was carried out using mixed methods. The intervention process theory is based on Ninacs’ conceptual model of individual empowerment. The Consolidated Framework For Implementation Research (CFIR) was mobilized a posteriori to analyze the process. PHIR stemmed from collaboration between a research team and two associations. The different stakeholders were involved in the evaluation process, as were, at certain times, persons in highly precarious situations. In Ouagadougou, a community-based dengue vector control intervention was deployed to address an essential but neglected need. As regards evaluation, we opted for a holistic, mixed method approach (effectiveness and process). The contents of the intervention were determined based on tacit knowledge, a community preference survey and solid evidence. The theoretical framework of the intervention consisted in an eco-biological model of vector control. The implementation analysis combined an internal assessment of implementation fidelity with an external CFIR process analysis. All stakeholders were involved in the evaluation process. DISCUSSION: Analysis confirmed not only the value of process evaluations in PHIR, but also the primordial importance of a rigorous approach. Stakeholder involvement is a major challenge to be addressed early in the planning of RISPs; with this in mind, effective and ethically sound assessment mechanisms need to be drawn up. Interdisciplinary evaluative approaches should be preferred, and the use of justified, relevant, and flexible frameworks is highly recommended. CONCLUSION: Lessons learned for those wishing to engage in the process evaluation of a public health intervention are hereby presented.

PubMed entry

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Ridde Valery, Coulibaly Abdourahmane et Gautier Lara (2023) « Case studies », LIEPP Methods Brief / Fiches méthodologiques du LIEPP (mai 12). https://hal.science/hal-04102953.

Résumé : Case studies consist of an in-depth analysis of one or more cases, using a variety of methods and theoretical approaches. The choice of cases (single or multiple) studied is crucial. Case studies are particularly suitable for studying the emergence and processes involved in policy implementation and for contributing to theory-based evaluations.

Mots-clés : ⛔ No DOI found.

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Ridde Valéry, Coulibaly Abdourahmane et Gautier Lara (2023) « Les études de cas », LIEPP Methods Brief / Fiches méthodologiques du LIEPP (mai 11). https://hal.science/hal-04102951.

Résumé : Les études de cas consistent à analyser de façon approfondie un ou plusieurs cas, à partir d’une diversité de méthodes et au regard d’approches théoriques. Le choix des cas (unique ou multiples) étudiés est crucial. Les études de cas sont particulièrement adaptées pour étudier l’émergence et les processus en jeu dans la mise en œuvre des politiques et pour participer aux évaluations basées sur la théorie.

Mots-clés : ⛔ No DOI found.

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Robin Julie (2023) « Knowledge transfer interventions on cancer in Africa and Asia: a scoping review », Poster novembre 3, AORTIC-Africa, Dakar, Sénégal.

Robin Julie, Schantz Clémence, Kanté Kadiatou, Dancoisne Aurélien et Ridde Valery (2023) « Knowledge transfer interventions on cancer in Africa and Asia : a scoping review », Protocols.io (novembre 14). https://protocols.cloud/view/knowledge-transfer-interventions-on-cancer-in-afri-c42eyybe.

Résumé : Introduction: Africa and Asia face many challenges related to knowledge transfer in the field of cancer diagnosis, treatment, survivorship, and end-of-life care. Some of these challenges include adherence to screening, confidence in the capabilities of modern medicine and the local health system, the ability of patients to make informed decisions about their treatment, the response of family members and society, the ability of the health system to improve the quality of survival of patients, and the ability of the authorities to implement appropriate and effective cancer control policies. It is therefore essential to understand how evidence and experiential knowledge can be better integrated into the health system and into the actions or decisions of those involved in cancer control.

Mots-clés : ⛔ No DOI found.

Rousseau A., Dubel-Jam M., Schantz Clémence et Gaucher L. (2023) « Barrier measures implemented in French maternity hospitals during the COVID-19 pandemic: A cross-sectional survey », Midwifery, 118 (mars 1), p. 103600. DOI : 10.1016/j.midw.2023.103600. https://www.sciencedirect.com/science/article/pii/S0266613823000037.

Résumé : Objectives The objectives of this survey were 1) to describe the changes over time of barrier measures in maternity units, specifically, co-parent visits and women wearing masks in birth rooms, and 2) to identify potential institutional determinants of these barrier measures. Design We used an online questionnaire to conduct a descriptive cross-sectional survey from May to July 2021. Setting All districts in mainland France. Participants Midwife supervisor of each maternity unit. Measurements Primary outcomes were “banning of visits” in the postnatal department during the first lockdown (March–May 2020), and “mandated mask-wearing in birth rooms” during the survey period (May–July 2021); the independent variables were maternity unit characteristics and location in a crisis area. Co-parent visits were considered only during the first lockdown as they were mostly allowed afterwards, and the wearing of masks was studied only during the survey period, as masks were unavailable for the population during the first lockdown. Results We obtained 343 responses, i.e., 75.2% of French maternity units. Visits to the postnatal department were forbidden in 39.3% of the maternity units during the first lockdown and in none during the study period. Maternity hospitals with neonatal intensive care units were the most likely to ban co-parent hospital visits (adjusted OR 2.34 [1.12; 4.96]). However, those were the maternity units least likely to encourage or require women to wear masks while pushing (adjusted OR, 0.31; 95% confidence interval [CI], 0.11–0.77). Maternity units in crisis areas (i.e., with very high case counts) during the first lockdown banned visits significantly more often (adjusted OR, 1.68; 95% CI, 1.05–2.70). Key conclusions Our study showed that barrier measures evolved during the course of the pandemic but remained extremely variable between facilities. Implications for practice Maternity units implemented drastic barrier measures at the beginning of the pandemic but were able to adapt these measures over time. It is now time to learn from this experience to ensure that women and infants are no longer harmed by these measures.

Mots-clés : Barrier measures, COVID-19, Maternity unit policies.

Rozée Virginie et Schantz Clémence (2023) « Accoucher pendant la pandémie du Covid-19 en France : d’un « tout s’est bien passé » au sentiment d’une maternité volée », Sciences sociales et santé, 41 (4) (décembre 1), p. 43-70. DOI : 10.1684/sss.2023.0259. https://www.jle.com/fr/revues/sss/e-docs/accoucher_pendant_la_pandemie_du_covid_19_en_france_dun_tout_sest_bien_passe_au_sentiment_dune_maternite_volee_350121/article.phtml?tab=texte.

Sambou C., Pourette Dolorès, Beaudrap Pierre De, Raho-Moussa M. et Allavena C. (2023) « Polypathologie des personnes âgées vivant avec le VIH : quelle gestion en médecine générale ? », Santé Publique, 35 (1), p. 37. DOI : 10.3917/spub.231.0037. https://hal.science/hal-04141930.

Résumé : Introduction : La polypathologie est une problématique de santé qui concerne de plus en plus de personnes vivant avec le VIH (PVVIH) et dont la fréquence augmente avec l'âge. Le recul actuel de l'hospitalo-centrisme devrait amener le médecin généraliste à occuper une place centrale dans le suivi extra-hospitalier des PVVIH âgées et polypathologiques. Notre étude cherche à comprendre la place qu'occupent réellement les médecins généralistes et les barrières qu'ils rencontrent dans la prise en charge des PVVIH âgées et polypathologiques. Méthodes : Nous présentons ici les résultats d'une étude ancillaire d'une précédente recherche (ANRS EP66-SEPTAVIH) qui évalue la fragilité chez les PVVIH âgées de 70 ans et plus. Elle repose sur des entretiens approfondis réalisés auprès de médecins généralistes et de PVVIH âgées de 70 ans et plus. Les données ont fait l'objet d'un traitement manuel et les thèmes et sous-thèmes identifiés ont été classés dans un tableau sous forme de grilles d'être soumis à une analyse thématique transversale. Résultats : À partir de 30 entretiens réalisés d'avril 2020 à juin 2021 auprès de 10 médecins généralistes et 20 PVVIH âgées de 70 ans et plus et polypathologiques, cette étude identifie les difficultés que les médecins généralistes rencontrent pour intervenir pleinement dans la prise en charge de ces patients. Leur suivi est caractérisé par des cloisonnements symboliques entre groupes de professionnels : morcellement organisationnel entre médecins généralistes et spécialistes, peur d'empiéter sur le rôle de l'autre professionnel de santé et absence fréquente de formalisation des rôles dans la coordination des soins. Conclusions : Afin de favoriser un suivi optimal et d'améliorer le vécu des PVVIH âgées, il est important que le rôle de chaque intervenant soit mieux défini pour un meilleur suivi partagé.

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Sandron Frédéric (2023) Vieillissement de la population et réchauffement climatique au 21e siècle : une crise en perspective ?, Working Papers du Ceped (56), Paris : Ceped. https://hal.science/hal-04136455.

Résumé : Les changements climatiques en cours ainsi que le vieillissement de la population mondiale sont deux mutations majeures du 21e siècle qui vont bouleverser nos sociétés. Beaucoup étudiés indépendamment par les spécialistes du climat et par les démographes, ces deux phénomènes sont plus rarement analysés dans leurs interrelations. C'est ce qui est proposé ici en étudiant plus spécifiquement l'impact du réchauffement climatique sur les conditions de vie et le bien-être des seniors.

Sandron_2023_Vieillissement de la population et réchauffement climatique au 21^e siècle.pdf 1.1 Mio

Schantz Clémence (2023) « Les mobilités de formation: le cas des études de spécialisation en oncologie au Bénin » présenté à 2ème Congrès National des Soins Palliatifs Thème: La souffrance en soins palliatifs, octobre 12, Bohicon, Bénin.

Schantz Clémence et Coulibaly Abdourahmane (2023) « Corps féminins amputés : cancers du sein et rapports de genre au Mali », Colloque international présenté à Colloque international Institut du Genre, juillet 6, Toulouse, France.

Schantz Clémence et Hancart Petitet Pascale (2023) « Circulation and Exportation of the Japanese Childbirth Model in Southern-East Asia. Preliminary Insights from Cambodia », in Rethinking Asia in World Politics, par Joanna Ciesielska-Klikowska, Łódź : Lodz University Press, p. 253-266. (Contemporary Asian Studies Series).

Schantz Clémence et Rozée Virginie (2023) « Accoucher pendant la pandémie de Covid-19 en France : la grande solitude des femmes », The Conversation. http://theconversation.com/accoucher-pendant-la-pandemie-de-covid-19-en-france-la-grande-solitude-des-femmes-198687.

Résumé : « Koh Lanta de la maternité » ou « Bulle sans Covid » : les expériences d’accouchement des Françaises durant la pandémie ont varié. Des recherches scientifiques ont fait le bilan.

Schantz Clémence, Tiet Mordjane, Evrard Anne, Guillaume Sophie, Boujahma Dounia, Quentin Bérénice, Pourette Dolorès et Rozée Virginie (2023) « A strong capacity to face the shock of the health crisis: MaNaO, a midwife-led birthing centre in France », Midwifery. DOI : 10.1016/j.midw.2023.103837.

Schoelen Leonie, Sebihi Abbes, Azab-Els Sherif et Sano Mariame (2023) « Diversity of epistemologies in African higher education: an interdisciplinary perspective on the contribution of digital communities of practice to equitable knowledge production », Curriculum Perspectives (juillet 24). DOI : 10.1007/s41297-023-00209-8. https://link.springer.com/10.1007/s41297-023-00209-8.

Résumé : Abstract This interdisciplinary article proposes a holistic approach to address challenges faced by African higher education owing to the shift to digital technology and online learning. The approach draws on theories of knowledge to promote equitable knowledge production and bridge the digital divide. The article highlights the potential of communities of practice as a complementary tool to indigenous methods and calls for the use of all available resources, including indigenous languages, to overcome existing inequalities and promote dynamic knowledge construction. The importance of understanding the historical influence of colonial and pre-colonial practices on epistemology is also emphasized. The article offers innovative approaches and insights to support equitable and inclusive knowledge production in African higher education contexts, with a focus on the Western region of the continent, facilitated by novel technologies that have been rolled out in learning institutions globally.

Serviant-Fine Thibaut, Arminjon Mathieu, Fayet Yohan et Giroux Élodie (2023) « Allostatic load: historical origins, promises and costs of a recent biosocial approach », BioSocieties (mai 26). DOI : 10.1057/s41292-023-00303-0. https://link.springer.com/10.1057/s41292-023-00303-0.

Résumé : Abstract This article provides a critical and genealogical analysis of the allostatic load research framework. AL research is used as a case study to analyse how the current biosocial context is articulated in the field of health inequalities research. Providing a contemporary analysis of AL studies with a genealogy of the AL concept, we show that the ambition to use biological tools to improve measurements, predictions, and ultimately public health action, is rooted in a history that predates current biosocial entanglements. We analyse the conceptual and methodological grounding of AL studies in relation to the ambitious propositions to address health inequalities they often convey. The difficulties in translating AL research findings into public health policies and the risks of biomedicalisation that could emerge through the use of AL are also addressed. While acknowledging these risks, however, we nuance the risk of depoliticisation associated with the biomedicalisation of social inequalities in health. In light of the historical analysis, we qualify the risks associated to a biologisation of social life that could emerge from AL research: it appears that these risks are more specifically rooted in methodological and epistemological problems that researchers would need to consider in the pursuit of AL research.

Texte intégral 743.6 kio (source)

Silhol Romain, Maheu-Giroux Mathieu, Soni Nirali, Fotso Arlette Simo, Rouveau Nicolas, Vautier Anthony, Doumenc-Aidara Clemence, Geoffroy Olivier, N'Guessan Kouassi Noel, Sidibe Younoussa, Kabemba Ode Kanku, Gueye Papa Alioune, Mukandavire Christinah, Vickerman Peter, Keita Abdelaye, Ndour Cheikh Tidiane, Ehui Eboi, Larmarange Joseph, Boily Marie-Claude et Team The ATLAS (2023) « Assessing the potential population-level impacts of HIV self-testing distribution among key populations in Cote d'Ivoire, Mali, and Senegal: a mathematical modelling analysis », medRxiv. DOI : 10.1101/2023.08.23.23294498. https://www.medrxiv.org/content/10.1101/2023.08.23.23294498v2.

Résumé : Background: A third of people living with HIV (PLHIV) in Western Africa had an undiagnosed infection in 2020. In 2019-2021, the ATLAS programme has distributed a total of 380 000 HIV self-testing (HIVST) kits to key populations (KP) including female sex workers (FSW) and men who have sex with men (MSM), and their partners in Cote d'Ivoire, Mali and Senegal. We predicted the potential impact of ATLAS and of national HIVST scale-up strategies among KP. Methods: A deterministic model of HIV transmission was calibrated to country-specific empirical HIV and intervention data over time. We simulated scenarios reflecting 1) the actual ATLAS HIVST distribution only over 2019-2021 (~2% of all tests done in countries), and 2) ATLAS followed by a scale-up of HIVST distribution to KP (total of ~570 000 kits distributed each year). Impacts on HIV diagnosis, new HIV infections and deaths were derived using counterfactual scenarios without HIVST. Findings: ATLAS was predicted to substantially increase HIV diagnosis among KP by the end of 2021, especially among MSM in Mali (94.3 percentage point [pp] increase), and a 1.0pp increase overall. ATLAS might have averted a median of 706 new HIV infections among KP over 2019-2028 in the 3 countries combined, especially among MSM, and 1794 new HIV infections (0.4-3.3% of all new HIV infections across countries) and 591 HIV-related deaths overall. HIVST scale-up increased HIV diagnosis at the end of 2028 by around 8pp among FSW and 33pp among MSM in every country. Overall increases ranged from 1.0pp (Cote d'Ivoire) to 11.0pp (Senegal). HIVST scale-up may avert 3-5% of new HIV infections among FSW, 3-10% among FSW clients, and 20-28% among MSM across countries (and 2-16% overall), and avert 13-18% of HIV-related deaths among MSM over 2019-2028. Interpretation: Scaling-up HIVST distribution among KP in Western Africa may substantially attenuate disparities in access to HIV testing and help reduce HIV infections and deaths among KP and their partners.

Silhol et al_2023_Assessing the potential population-level impacts of HIV self-testing.pdf 200.6 kio (source)

Mick Carola et Godenzzi Juan Carlos (2023) « Discurso y poder en potencia. En torno a la interculturalidad en el Perú », in Lenguaje y cultura: Homenaje a Angelita Martínez, éd. par Adriana Speranza, Gabriela Bravo De Laguna, et Ivana Mestriner, La Plata : Universidad Nacional de La Plata. Facultad de Humanidades y Ciencias de la Educación, p. 349-380. ISBN : 978-950-34-2207-6. https://libros.fahce.unlp.edu.ar/index.php/libros/catalog/book/215.

Résumé : Este volumen en homenaje a la labor académica y docente de Angelita Martínez pretende reconocer la trayectoria de una investigadora incansable. Su obra se conoce en los espacios de mayor difusión de la ciencia lingüística. En esta Facultad desarrolló su tarea docente y de investigación, en primer término, desde la cátedra de Filología Hispánica, y luego desde la cátedra de Lingüística. Actualmente conduce el Centro de Estudios e Investigaciones Lingüísticas y la Maestría en Lingüística. Su labor le ha permitido consolidar vínculos académicos y personales tanto nacionales como internacionales, que se plasman en esta compilación a través de una serie de trabajos de lingüistas pertenecientes a distintas perspectivas teóricas y espacios geográficos que comparten su interés por el funcionamiento del lenguaje. Se incluyen además los trabajos de discípulas que han finalizado sus posgrados y que dan cuenta del camino transitado y los logros alcanzados de la mano de su generosa formadora.

Stannah James, Soni Nirali, Lam Jin Keng Stephen, Giguère Katia, Mitchell Kate M, Kronfli Nadine, Larmarange Joseph, Moh Raoul, Nouaman Marcellin, Kouamé Gérard Menan, Boily Marie-Claude et Maheu-Giroux Mathieu (2023) « Trends in HIV testing, the treatment cascade, and HIV incidence among men who have sex with men in Africa: a systematic review and meta-analysis », The Lancet HIV, p. S235230182300111X. DOI : 10.1016/S2352-3018(23)00111-X. https://linkinghub.elsevier.com/retrieve/pii/S235230182300111X.

Sween-Cadieux E. Mc, Dagenais C. et Ridde Valéry (2023) « Une évaluation mixte d'un atelier délibératif sur les accidents de la route au Burkina Faso », Ed. Science et Bien Commun. https://hal.science/hal-04130592.

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Teixeira Luis (2023) « Cancers gynécologiques et mammaires: dernières avancées thérapeutiques », Colloque international présenté à 4ème journées scientifiques du Collège National des Gynécologues Obstétriciens du Bénin (CNGOB), septembre 14, Cotonou, Bénin.

Teixeira Luis (2023) « D'une mort biologique à une mort sociale: souffrance de femmes africaines venues pour soins en France » présenté à 2ème Congrès National des Soins Palliatifs Thème: La souffrance en soins palliatifs, octobre 12, Bohicon, Bénin.

Touré Laurence, Boivin Pauline, Diarra Yacouba, Diabaté Seydou et Ridde Valéry (2023) « Innovations in mutuality: challenges and learnings for the Universal Health Insurance Plan in Mali », BMJ Global Health, 7 (Suppl 9) (mars), p. e011055. DOI : 10.1136/bmjgh-2022-011055. https://gh.bmj.com/lookup/doi/10.1136/bmjgh-2022-011055.

Résumé : Background Many Sahel countries in Africa are looking for solutions for universal health coverage (UHC). Mali is in the process of adopting the Universal Health Insurance Plan, which allows for the mutualisation of existing schemes. Its operationalisation requires numerous adjustments to the current mutualist proposal and innovations in the system. The study focuses on innovations experienced in mutuality and their conditions of scale for UHC in Mali. Methods This is qualitative research by multiple case studies. It is based on the collection of data by interviews (n=136), at a national and local level, on the analysis of documents (n=42) and a long field observation (7 months). The analytical framework concerns the dissemination and maintenance of health innovations (Greenhalgh et al, 2004). Result The analysis of this innovation shows an interest in the technical and institutional viability that determines its performance and scale-up. The procrastination and scepticism displayed at the highest level of the state and the international level, the reluctance, both financial and ideological, to renew the old mutualist proposal, penalise this Malian experiment. Conclusion This innovation is a decisive step in ensuring the health coverage of Mali’s agricultural and informal sectors. The reform will need to be amplified and supported in the future to expect the scale-up of a cheaper, technically and institutionally more efficient system. Without a political intention to mobilise national resources and accept a fundamental paradigm shift in health financing, the search for the financial viability of mutuality may, again, be at the expense of the performance.

Texte intégral 718.5 kio (source)

Touzani Rajae, Schultz Émilien, Vandentorren Stéphanie, Arwidson Pierre, Guillemin Francis, Bouhnik Anne Déborah, Rouquette Alexandra et Mancini Julien (2023) « Digital contact tracing during the COVID-19 pandemic in France: Associated factors and reasons for non-use », International Journal of Medical Informatics, 171. DOI : 10.1016/j.ijmedinf.2023.104994. https://hal.science/hal-04068539.

Résumé : Objectives: To estimate the proportion of users of the TousAntiCovid app(lication) and identify factors associated with its non-use for contact tracing. Methods: We conducted an online survey of a quota sample of French adults between 8 and 18 January 2021. Three categories of TousAntiCovid use were considered: contact tracing, other or temporary usage, and no use. A weighted multiple logistic regression was performed to analyze the factors associated with these different uses. Results: Among the 1 000 respondents, 63.3% declared they had never downloaded the TousAntiCovid app, 23.5% used it for contact tracing. The remaining 13.2% did not enable contact tracing, mainly because of excessive battery consumption and fear of misuse of personal data. Trust in political representatives, financial deprivation and other factors were associated with never downloading the app. Conclusion: This study confirms the previously suggested links between trust in political representatives, financial deprivation and the use of contact tracing apps in France.

PubMed entry

Zitti Tony, Coulibaly Abdouramane, Gali-Gali Idriss Ali Zakaria, Ridde Valery et Turcotte-Tremblay Anne-Marie (2023) « A comparative study of community verification processes in the context of performance-based financing in Mali and Burkina Faso », International Journal of Public Sector Management (septembre 4). DOI : 10.1108/IJPSM-02-2023-0063. https://www.emerald.com/insight/content/doi/10.1108/IJPSM-02-2023-0063/full/html.

Résumé : Purpose This article compares the processes of community verification (CV) and user satisfaction surveys during the implementation of performance-based financing (PBF) in Mali and Burkina Faso. Design/methodology/approach The authors adopted a qualitative approach based on a multiple-case study design. Data were collected from August 10 to 25, 2017, in Mali, and from January to May 2016 in Burkina Faso. In Mali, 191 semi-structured interviews were conducted with investigators (people who collect information from health centre users in the communities, using survey tools), users, users' relatives, and health workers in three of the 10 health districts in the Koulikoro region. In Burkina Faso, 241 non-participatory observation sessions were recorded in a research diary, and 92 semi-structured interviews and informal discussions were conducted with investigators, community verifiers, users, PBF support staff at the national level, and administrative staff in one of the 15 health districts involved in PBF. The data were analysed inductively. Findings In both Mali and Burkina Faso, the delayed availability of survey forms led to a delay in starting the surveys. In Mali, to get off to a quick start, some investigators went to health centres to conduct the sampling with their supervisors. In both countries, investigators reported difficulties in finding certain users in the community due to incorrect spelling of names, lack of telephone details, incomplete information on the forms, common or similar sounding names within the community, and user mobility. There was little interference from health workers during user selection and surveys in both countries. In both countries, many surveys were conducted in the presence of the user's family (husband, father-in-law, brother, uncle, etc.) and the person accompanying the investigator. Also in both countries, some investigators filled in forms without investigating. They justified this data fabrication by the inadequate time available for the survey and the difficulty or impossibility of finding certain users. In both countries, the results were not communicated to health centre staff or users in either country. Research limitations/implications CV and user satisfaction surveys are important components of PBF implementation. However, their implementation and evaluation remain complex. The instruments for CV and user satisfaction surveys for PBF need to be adapted and simplified to the local context. Emphasis should be placed on data analysis and the use of CV results. Originality/value There are similarities and differences in the CV process and user satisfaction surveys in Mali and Burkina Faso. In Mali, the data from the user satisfaction survey was not analyzed, while in Burkina Faso, the analysis did not allow for feedback. The local non-governmental organisations (NGOs) that carried out the CV were pre-financed for 50% of the amount in Mali. In Burkina Faso, community-based organisations (CBOs) were not pre-financed. The lack of financing negatively impacted the conduction of the surveys. In Mali, fraudulent completion of survey forms by interviewers was more common in urban than in rural areas. In Burkina Faso, the frauds concerned consultations for children under five years of age. In Burkina Faso, the survey form was not adapted to collect data on the level of satisfaction of the indigent. Key messages There were similarities and differences in the community verification (CV) processes in Mali and Burkina Faso. In both Mali and Burkina Faso, tracing users within their community was difficult for several reasons, including incorrect or incomplete information on forms, common or similar names, and user mobility. In both countries, there was no feedback on the results of the CV process to health centre staff or users. Survey forms were falsified by investigators in both countries. In Mali, falsification was more common in urban than in rural areas. In Burkina Faso, falsification was more often observed for consultations for children under five years of age.

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