Publications des membres du Ceped

2022


  • Pérouse de Montclos Marc-Antoine (2022) Les enjeux politiques de la démographie des religions au Nigeria (51), Paris : Ceped, 14 p. https://www.ceped.org/wp.
    Résumé : Pays le plus peuplé d’Afrique, le Nigeria est souvent présenté comme un territoire situé sur une ligne de fracture opposant des mondes sahéliens et musulmans, d’une part, et chrétiens et tropicaux, d’autre part. Le dénombrement des communautés de croyance y revêt donc une forte dimension symbolique qui dévoile de nombreux enjeux politiques au niveau national et local. Pour en comprendre les tenants et aboutissants, cette analyse revient en conséquence sur les tentatives avortées de quantifi-cation des affiliations religieuses depuis la période coloniale. Une deuxième partie synthétise l’état des connaissances à ce sujet. Dans une troisième partie, enfin, sont analysés les enjeux et les tensions politiques qui expliquent pourquoi, désormais, les autorités évitent soigneusement d’intégrer dans les recensements des modules portant sur les croyances des Nigérians.
  • Petit Véronique (2022) « The mental health and international migration nexus in Senegal », Communication atelier de recherche présenté à Workshops on models of environmental migration in Senegal organisé par Columbia University- Boston University - Princeton, Saly, Sénégal.
  • Petit Véronique (2022) « La santé mentale face à l’urgence climatique : les effets de l’environnement sur le psychisme », Présentation débat vulgarisation présenté à Jotaay climat, février 3, Institut français, Dakar, Sénégal.

  • Petit Véronique (2022) « Des mobilités constitutives d’un espace transnational en santé mentale : des marges sénégalaises à la santé globale. », Communication colloque présenté à Rencontres d’études africaines en France (REAF), Atelier A-68 Migrations and health : Borders, Heath, actors., juin 29, Toulouse, Université Le Mirail. https://reaf2022.sciencesconf.org/.

  • Petit Véronique (2022) « Recherche en santé mentale : parcours thérapeutiques et migratoires de migrants de retour au Sénégal », Atelier présenté à Atelier mobilité et diaspora, mars 10, Dakar, Institut Français-OFII Office français de l’immigration et l’intégration. https://www.ofii.fr/atelier-mobilite-et-diaspora-au-senegal/.

  • Petit Véronique (2022) « Enquêter sur la psychiatrie au Sénégal : continuum et décentrement pour analyser la santé mentale globale dans le Global South », Communication colloque présenté à Rencontres d’études africaines en France (REAF), atelier A1 Les ficelles du métier., juillet 1, Toulouse, Université Le Mirail. https:https://reaf2022.sciencesconf.org/.

  • Petit Véronique (2022) « Les femmes actrices de la santé mentale : soignantes, patientes, accompagnantes », Journée scientifique présenté à Journée internationale de la femme, mars 8, Campus international franco-sénégalais, IRD Hann, Dakar Sénégal. français.


  • Petit Véronique (2022) « La santé mentale : en enjeu de développement sous-estimé », in Population et questions de développement, éd. par Yves Charbit, London : ISTE Editions, p. 173-199. ISBN : 978-1-78948-051-1. https://www.istegroup.com/fr/produit/population-et-questions-de-developpement/.


  • Petit Véronique (2022) « Mental health: an underestimated development issue », in Population and development issues, éd. par Yves Charbit, Paris : ISTE WILEY, p. 157-181. ISBN : 978-1-78945-051-4. https://www.iste.co.uk/book.php?id=1877.
    Résumé : One of the major challenges facing the world today is the interaction between demographic changes and development. Rather than the usual view that the population itself is the main problem, Population and Development Issues argues that it is just one factor among many others, such as poverty, illiteracy, poor health, unemployment, the condition of women and climate change. This book analyzes the relationships between the key demographic variables (fertility, morbidity and mortality, migration, etc.) and major development issues, notably education, employment, health, gender, social and geographical inequalities and climate concerns. Bringing together contributions from specialists across every field, it presents empirical data simply and clearly alongside theoretical reflections.

  • Plazy Mélanie, Nouaman Marcellin, Becquet Valentine, Agoua Aline, Zébago Clémence, Dao Hervé, Coffie Patrick A, Eholié Serge, Larmarange Joseph et ANRS 12381 PRINCESSE study group (2022) « Delays to PrEP initiation among female sex workers in Côte d'Ivoire (ANRS 12381 PRINCESSE project) » (poster), présenté à 24th International AIDS Conference, Montreal. https://programme.aids2022.org/Abstract/Abstract/?abstractid=6824.
    Résumé : BACKGROUND: To describe the delays to initiation of oral pre-exposure prophylaxis (PrEP) among female sex workers (FSW) in Côte d''Ivoire. METHODS: The ANRS 12381 PRINCESSE project is a single-arm interventional cohort aiming to evaluate the implementation of a comprehensive and community-based care offer among FSW aged '¥18 years in the San Pedro region since end-2019, through a mobile clinic operating on 10 prostitution sites (visited every two weeks). PrEP is offered to all HIV-positive FSW after verifying the creatinine level (results valid for one month). We described the time between FSW's interest for PrEP and PrEP initiation (or end of follow-up) among HIV- and hepatitis B virus-negative (HBsAg-) FSW included until end-October 2021. The probability of PrEP initiation since PrEP interest is described through a Kaplan-Meier curve censored on end-November 2021 (an analysis censored at the date of the last visit was also conducted). RESULTS: Of the 362 FSW included in the PRINCESSE cohort, 302 were HIV-/AgHBs-, and for 296 of them, PrEP was presented by medical staff (95.2% at inclusion). In total, 292 FSW expressed PrEP interest, and 192 (65.8%) initiated PrEP: 18 on the same day (the biological test having been performed during a previous visit), 148 during the next visit (median time since interest: 3 weeks [Inter-Quartile Range: 2-6]) and 26 during a subsequent visit (median time: 20 weeks [9-36]). The probability of PrEP initiation after PrEP interest was 39.0% at 1 month and 56.6% at 3 months (censoring on the date of the last visit, these proportions were 50.7% and 74.6%, respectively). Among the 100 FSW who did not initiate PrEP despite expressing interest, 68 were never seen again in the project; 4 declared that they were no longer interested in PrEP (median time since interest: 12 weeks [10-19]), 1 was tested HIV+ (delay of 2 weeks), and 27 were seen >1 month later (their biological tests were no longer valid). CONCLUSIONS: Despite strong PrEP interest among FSW, PrEP initiation remained suboptimal. Barriers to PrEP initiation should be more explored and considered to find appropriate solutions to make PrEP effective among this specific key population.
  • Plazy Mélanie, Nouaman Marcellin, Becquet Valentine, Agoua Aline, Zebago Clémence, Zonhoulou Dao Hervé, Coffie Patrick, Eholie Serge, Larmarange Joseph et ANRS 12381 PRINCESSE Study Team (2022) « Retards et obstacles à l’initiation de la PrEP orale chez les travailleuses du sexe en Côte d’Ivoire (projet ANRS 12381 PRINCESSE) » (poster #PJ181), présenté à AFRAVIH, Marseille.
    Résumé : Objectifs Décrire les retards et obstacles à l’initiation de la prophylaxie pre-exposition (PrEP) orale des travailleuses du sexe (TS) en Côte d’Ivoire. Matériels et Méthodes Le projet ANRS 12381 PRINCESSE est une cohorte interventionnelle mono-bras, dont les inclusions ont débuté le 26/11/2019, qui vise à évaluer la mise en oeuvre d’une offre de soins globale et communautaire auprès des TS de ≥18 ans dans la région de San Pedro. Il s’organise autour d’une clinique mobile se déplaçant sur 10 sites prostitutionnels (chaque site étant visité toutes les deux semaines) et d’une clinique fixe. La PrEP est proposée à toutes les TS VIH- ; l’initiation est possible après vérification du taux de créatinine (déterminé via un bilan biologique ; résultats valables un mois). L’analyse présentée se limite aux TS VIH- et séronégatives au virus de l’hépatite B (AgHBs-) incluses jusqu’au 30/09/21, et décrit ce qu’il s’est passé entre l’intérêt exprimé pour la PrEP et la prescription de la PrEP (ou la fin de suivi). La probabilité d’initiation de la PrEP après avoir exprimé son intérêt est décrite via une courbe de Kaplan-Meier censurée au 23/11/21 (une analyse censurée à la date de dernière visite a aussi été conduite). Résultats Parmi les 362 TS étaient incluses dans la cohorte PRINCESSE, 302 étaient VIH-/AgHBs-. Sur les 296 TS à qui la PrEP a été présentée (95,2% à l’inclusion), 292 se sont déclarées intéressées (99,7% le jour même). Parmi elles, 192 (65,8% des TS intéressées) ont reçu une prescription de PrEP : 18 le jour même de l’intérêt exprimé (le bilan biologique ayant été réalisé lors d’une précédente visite), 148 lors de la visite suivante (délai médian depuis l’intérêt : 3 semaines [Intervalle Inter-Quartile : 2-6]) et 26 lors d’une visite ultérieure (délai médian : 20 semaines [9-36], soit parce qu’elles n’étaient temporairement plus intéressées (n=3), soit parce qu’elles sont revenues tardivement). Au final, la probabilité de prescription de la PrEP après avoir exprimé son intérêt est de 39,0% à 1 mois et de 56,6% à 3 mois (en censurant sur la date de dernière visite, ces proportions sont respectivement de 50,7% et 74,6%). Parmi les 100 TS qui n’ont pas initié la PrEP malgré un intérêt exprimé, 68 n’ont jamais été revues dans le projet ; parmi les 32 TS qui sont revenues à au moins une deuxième visite suivant leur intérêt pour la PrEP, 4 ont déclaré ne plus être intéressées par la PrEP (délai médian depuis l’intérêt : 12 semaines [10-19]), 1 a été dépistée VIH+ (délai de 2 semaines) et 27 sont revenues plus d’un mois après (leur bilan biologique n’était plus valable). Conclusion Malgré un fort intérêt exprimé pour la PrEP, son initiation reste sous-optimale parmi les TS de PRINCESSE. Les premières analyses exploratoires et discussions avec les équipes terrain suggèrent plusieurs obstacles (mobilité des TS, intérêt mal perçu pour la PrEP, lourdeur du suivi, fidélité des sorties de la clinique mobile), et confirment la nécessité de trouver des solutions adaptées pour rendre la PrEP effective chez les TS.


  • Porfilio-Mathieu Lyann, Pigeon-Gagné Émilie, Dagenais Christian et Ridde Valéry (2022) « Prevalence and determinants of mental health among an indigent population in rural Burkina Faso: a cross-sectional study », Journal of Global Health Reports, 6 (avril 25). DOI : 10.29392/001c.33820. https://www.joghr.org/article/33820-prevalence-and-determinants-of-mental-health-among-an-indigent-population-in-rural-burkina-faso-a-cross-sectional-study.


  • Pourette Dolorès (2022) « Penser ensemble les objets sida et immigration », Anthropologie & Santé, 24 bis. N° dédié à Sandrine Musso (juin 13). DOI : 10.4000/anthropologiesante.10874. https://journals.openedition.org/anthropologiesante/10874.
    Résumé : La scène du sida est donc aussi un observatoire de choix des évolutions contemporaines du traitement de l’altérité dans la société française. Qu’il s’agisse de la production sociale des dynamiques de l’épidémie, de polémiques relatives à l’invisibilité statistique et à la gestion « postcoloniale » des populations immigrées, de l’adaptation socioculturelle des messages et politiques préventifs, la lutte contre le sida constitue un observatoire de tout premier choix des enjeux attachés à l’inte...
  • Pourette Dolorès (2022) « Etude qualitative des freins et leviers au dépistage du cancer du col de l’utérus à La Réunion » (Communication orale), présenté à Conférence de l'Institut Pasteur de Madagascar, Antananarivo.
  • Pourette Dolorès (2022) « Inégalités d’accès à la prévention du cancer du col de l’utérus à La Réunion » (Communication orale), présenté à AFRAVIH, Marseille.
  • Pourette Dolorès et Cripps Amber (2022) « Maternité, santé reproductive et rapport des femmes au médical à la Réunion » (Communication orale), présenté à Conférence de restitution de la recherche Mater-Covid19, Sainte-Clotilde, La Réunion.
  • Pourette Dolorès, Cripps Amber, Desprès Caroline, Bardou Marc et Dumont Alexandre (2022) « Améliorer la prévention du cancer du col de l’utérus à La Réunion par un dispositif d’auto-prélèvement à domicile. Résultats du volet qualitatif du programme RESISTE » (Poster), présenté à CoRES. Congrès de Recherche en Santé de l'océan Indien, Saint-Leu, La Réunion.


  • Pourette Dolorès, Cripps Amber, Guerrien Margaux, Desprès Caroline, Opigez Eric, Bardou Marc et Dumont Alexandre (2022) « Assessing the Acceptability of Home-Based HPV Self-Sampling: A Qualitative Study on Cervical Cancer Screening Conducted in Reunion Island Prior to the RESISTE Trial », Cancers, 14 (6), p. 1380. DOI : 10.3390/cancers14061380. https://www.mdpi.com/2072-6694/14/6/1380.
    Résumé : Cervical cancer incidence and mortality rates are 2 to 3 times higher in the overseas department of Reunion compared with mainland France. RESISTE’s cluster-randomized controlled trial aims to test the effectiveness of home-based self-sampling (HBSS) through a high-risk oncogenic papillomavirus test sent out by post to women who have not been screened in the past 3 years, despite having been invited to do so through a reminder letter. Prior to the trial, qualitative research was carried out to understand screening barriers and assess anticipated acceptability. Semi-structured interviews were conducted with 35 women and 20 healthcare providers. Providers consider HBSS a viable method in reaching women who tend not to visit a doctor regularly, or who are reluctant to undergo a smear pap, as well as those who are geographically isolated. They considered, however, that women would require support, and that outreach was necessary to ensure more socially isolated women participate. The majority of the women surveyed were in favour of HBSS. However, two-thirds voiced concerns regarding the test’s efficiency and their ability to perform the test correctly, without harming themselves. Based on these findings, recommendations were formulated to reassure women on usage and quality, and to help reach socially isolated women.
    Mots-clés : cervical cancer screening, home-based self-sampling, HPV testing, qualitative study, Reunion Island, social disadvantage, social isolation, socio-economic insecurity.
  • Pourette Dolorès, Rakotoarisoa Onintsoa, Louault Marion, Rakotomanana Elliot et Mattern Chiarella (2022) « Vers davantage de care dans la prise en charge du VIH ? Reconfiguration des collaborations entre patient.es, soignant.es, acteur.trices associatifs sous l’effet de la pandémie de Covid-19 à Antananarivo, Madagascar » (Communication orale), présenté à Anthropologie et Covid-19. Etats, expériences et incertitudes en temps de pandémie. Colloque international francophone multisite de l'AMADES, Marseille.
  • Pourette Dolorès, Rakotoarisoa Onintsoa, Louault Marion, Rakotomanana Elliot et Mattern Chiarella (2022) « Effets de la crise Covid-19 sur le rapport aux soins des personnes vivant avec le VIH à Antananarivo, Madagascar : entre ruptures de suivi et renforcement de la confiance envers les traitements et les soignants » (Poster PJ331), présenté à AFRAVIH, Marseille.


  • Pourraz Jessica (2022) « Making medicines in post-colonial Ghana: State policies, technology transfer and pharmaceuticals market », Social Science & Medicine, 311 (octobre), p. 115360. DOI : 10.1016/j.socscimed.2022.115360. https://linkinghub.elsevier.com/retrieve/pii/S0277953622006669.
    Résumé : The COVID-19 epidemic has highlighted the risks of shortages resulting from dependence on medicine imports. Today's situation where a few companies in the Global North control COVID-19 vaccine production is having dire consequences on African countries' access. However, the challenges surrounding local production of medical products in Africa are long-standing issues dating back to independence. Using Ghana as a case study, this paper looks primarily at how the dependence on medicine imports can be understood as the result of policies implemented since independence, as well as the changes that the Ghanaian State has undergone in reaction to international events and the evolution of the structure of global pharmaceutical capital. It examines the policies associated with the Ghanaian State's project to promote local pharmaceutical production, from independence to the present, and the role that non-state actors such as pharmaceutical companies have played. Based on an historical political economy approach, it highlights how the roles of the State and its forms of intervention have evolved over time, from planning (right after independence), to implementing (during the global crisis of the 1970s–1980s), and finally to regulating (from the 1990–2000s onward). This paper draws on 14 months of PhD research fieldwork (2014–2018). It consists of interviews (n = 50) with Ghanaian actors in the pharmaceutical sector, observations in a pharmaceutical plant in Accra, and research into archives at the Public Records and Archives Administration Department (PRAAD) of the Ministry of Industry.


  • Pourraz Jessica (2022) « Making medicines in post-colonial Ghana: State policies, technology transfer and pharmaceuticals market », Social Science & Medicine, 311 (115360) (octobre). DOI : 10.1016/j.socscimed.2022.115360. https://reader.elsevier.com/reader/sd/pii/S0277953622006669?token=D3412CC0309343F911B2B715FF8CDE2898F1F44BAD66D0B72304D7DE92AB726BBC75B05FA087BD3174EBC5586182F693&originRegion=eu-west-1&originCreation=20220921114328.
    Résumé : The COVID-19 epidemic has highlighted the risks of shortages resulting from dependence on medicine imports. Today's situation where a few companies in the Global North control COVID-19 vaccine production is having dire consequences on African countries' access. However, the challenges surrounding local production of medical products in Africa are long-standing issues dating back to independence. Using Ghana as a case study, this paper looks primarily at how the dependence on medicine imports can be understood as the result of policies implemented since independence, as well as the changes that the Ghanaian State has undergone in reaction to international events and the evolution of the structure of global pharmaceutical capital. It examines the policies associated with the Ghanaian State's project to promote local pharmaceutical production, from independence to the present, and the role that non-state actors such as pharmaceutical companies have played. Based on an historical political economy approach, it highlights how the roles of the State and its forms of intervention have evolved over time, from planning (right after independence), to implementing (during the global crisis of the 1970s–1980s), and finally to regulating (from the 1990–2000s onward). This paper draws on 14 months of PhD research fieldwork (2014–2018). It consists of interviews (n = 50) with Ghanaian actors in the pharmaceutical sector, observations in a pharmaceutical plant in Accra, and research into archives at the Public Records and Archives Administration Department (PRAAD) of the Ministry of Industry. Keywords: Ghana; Postcolonial; Pharmaceutical markets; Public policies; Technology transfer; Global health

  • Quet Mathieu (2022) Flux : comment la pensée logistique gouverne le monde, Paris : Zones, 157 p. ISBN : 978-2-35522-177-4.

  • Quet Mathieu (2022) Illicit medicines in the Global South: public health access and pharmaceutical regulation, Abingdon, Oxon ; New York, NY : Routledge, 1 p. ISBN : 978-1-00-046324-8 978-1-00-319476-7.
    Résumé : "This book investigates pharmaceutical regulation and the public health issue of fake or illicit medicines in developing countries. The book analyses the evolution of pharmaceutical capitalism, showing how the entanglement of market and health interests has come to shape global regulation. Drawing on extensive fieldwork in India, Kenya and Europe, it demonstrates how large pharmaceutical companies have used the fight against fake medicines to serve their strategic interests and protect their monopolies, sometimes to the detriment of access to medicines in developing countries. The book investigates how the contemporary dynamics of pharmaceutical power in global markets have gone on to shape societies locally, resulting in more security-oriented policies. These processes highlight the key consequences of contemporary "logistical regimes" for access to health. Providing important insights on how the flows of commodities, persons, and knowledge shape contemporary access to medicines in the developing countries, this book will be of considerable interest to policy makers and regulators, and to scholars and students across sociology, science and technology studies, global health, and development studies"--
    Mots-clés : Black market, Developing countries, Drug accessibility, Drug control, Drugs, Government policy, Law and legislation, Pharmaceutical industry, Product counterfeiting, Public health, Standards.
    Note Note
    "Translation from French Edition: Impostures pharmaceutiques. Médicaments illicites et luttes pour l'accès à la santé by © Editions La Découverte, Paris, 2018."
    Note Note
    Introduction: Faith in Fakes? -- In the beginning, a conflict -- The pharmaceutical globalization -- Selling at all costs -- The regulatory turn to security -- The exercise of pharmaceutical control -- Logistic regimes and the exercise of power -- Diverting flows, contesting power


  • Rault-Chodankar Yves-Marie (2022) « ‘We care… because care is growth’. The low-tech imaginaries of India's small-scale pharmaceutical enterprises », SSM - Qualitative Research in Health, 2 (décembre), p. 100144. DOI : 10.1016/j.ssmqr.2022.100144. https://linkinghub.elsevier.com/retrieve/pii/S2667321522001068.
    Résumé : Since the early 2000s, the development of India's generic industry has generated a lot of hope and interest amongst researchers and practitioners of Global Health. This article documents the ambiguous dreams, aspirations, and hopes of the managers of micro, small, and medium companies involved in manufacturing, marketing, and distributing low-cost generic medicine. The analysis draws on semi-structured interviews with managers (n ​= ​66) and shows that they contrast sharply with the universalist, tech-intensive, and salvationary imaginaries often associated with the global pharmaceutical industry. On the one hand, India's small-scale entrepreneurs see themselves as instrumental to their family's financial welfare and the economic development of their local social groups. On the other hand, they like to imagine themselves as part of India's emergence on the international stage and better global access to affordable medicine. Such imaginaries form a low-tech approach to Global Health where generic pharmaceuticals are not taken as transformative technologies but are meant to play specific socioeconomic roles at different scales.


  • Rault-Chodankar Yves-Marie et Kale Dinar (2022) « ‘Manufacturers without factories’ and economic development in the Global South: India’s pharmaceutical firms », Journal of Economic Geography (mai 23), p. lbac013. DOI : 10.1093/jeg/lbac013. https://academic.oup.com/joeg/advance-article/doi/10.1093/jeg/lbac013/6590741.
    Résumé : Abstract Global value chain/global production network studies have extensively documented the role of lead firms from the Global North in economic development in the Global South, including as ‘manufacturers without factories’ (MWFs). However, the role of local firms in sourcing from suppliers has been overlooked. In this article, we report the findings of a qualitative study and demonstrate that the local MWFs helped establish India as the leading supplier of pharmaceuticals worldwide and in the Global South. We show how the different types of local MWFs (‘propagandists’, ‘pioneers’, ‘connectors’ and ‘adaptors’) impact the strategic coupling, industrial upgrading and governance in South–South value chains and contribute to regional economic development.


  • Ravalihasy Andrainolo, Kardaś-Słoma Lidia, Yazdanpanah Yazdan et Ridde Valéry (2022) « Quantitative methods used to evaluate impact of health promotion interventions to prevent HIV infections: a methodological systematic review protocol », Systematic Reviews, 11 (1) (mai 6), p. 87. DOI : 10.1186/s13643-022-01970-z. https://doi.org/10.1186/s13643-022-01970-z.
    Résumé : Combination prevention is currently considered the best approach to combat HIV epidemic. It is based upon the combination of structural, behavioral, and biomedical interventions. Such interventions are frequently implemented in a health-promoting manner due to their aims, the approach that was adopted, and their complexity. The impact evaluation of these interventions often relies on methods inherited from the biomedical field. However, these methods have limitations and should be adapted to be relevant for these complex interventions. This systematic review aims to map the evidence-based methods used to quantify the impact of these interventions and analyze how these methods are implemented.
    Mots-clés : Combination HIV prevention, Evidence-based impact evaluation, Health promotion, Mathematical methods, Statistical methods, Study design.


  • Ridde Valéry, Ba Mouhamadou Faly, Guyot Marion, Kane Babacar, Mbow Ndeye Bineta, Senghor Ibrahima et Faye Adama (2022) « Factors that foster and challenge the sustainability of departmental health insurance units in Senegal », International Social Security Review, 75 (2) (avril), p. 97-117. DOI : 10.1111/issr.12300. https://onlinelibrary.wiley.com/doi/10.1111/issr.12300.
    Résumé : In an effort to establish universal health coverage (UHC), Senegal set up two departmental health insurance units (UDAM) to scale-up health insurance to rural communities. Part of this innovation meant that health insurance was no longer managed by volunteers, but by professionals. Several years after the conclusion of the project in 2017 that supported their initial development, both UDAMs still operate successfully. This mixed methods research aims to understand the factors that have contributed to the sustainability of both UDAMs, as well as discuss the remaining challenges. The factors deemed favourable to sustainability are actions undertaken to ensure financial stability and organizational risk taking. However, the mobilization of the population, relationships with health professionals and the role of the State have been more difficult to organize. Challenges concern the payment of subsidies and the supply of medicines by the State and partnership with the health care system, the maintenance of contributions, the digitalization of administration, as well as fraud and abuse.


  • Ridde Valery, Carillon Severine, Desgrées du Loû Annabel et Sombié I (2022) « Analyzing implementation of public health interventions : a need for rigor, and the challenges of stakeholder involvement », Revue d'Épidémiologie et de Santé Publique (juillet), p. S0398762022003650. DOI : 10.1016/j.respe.2022.06.001. https://linkinghub.elsevier.com/retrieve/pii/S0398762022003650.
    Résumé : Abstract 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.


  • Ridde Valéry et Faye Adama (2022) « Policy response to COVID-19 in Senegal: power, politics, and the choice of policy instruments », Policy Design and Practice (avril 28), p. 1-20. DOI : 10.1080/25741292.2022.2068400. https://www.tandfonline.com/doi/full/10.1080/25741292.2022.2068400.
    Résumé : The objective of the paper is to understand how Senegal formulated its policy response to the COVID-19 pandemic. The response was rapid, comprising conventional policy instruments used previously for containing Ebola. The policymaking process involved several agencies, which resulted in significant leadership and coordination problems. In addition, community participation and engagement with relevant scientific communities were limited, despite their recognized importance in fighting medical crises. Instead, international donors had a significant influence on the choice of policy tools. The paper contributes to contemporary thinking on the autonomy of policy instruments-the idea that preferences for policy instruments are stable, independent of the particular policy problems being addressed and goals being pursued-which has recently been applied to policies in Africa. The study calls for a review of how academics, civil society, and decision-makers must collaborate to design public policies and policy tools based on evidence and context, not only politics.


  • Ridde Valéry et Faye Adama (2022) « Challenges in Implementing the National Health Response to COVID-19 in Senegal », Global Implementation Research and Applications (août 9). DOI : 10.1007/s43477-022-00053-4. https://link.springer.com/10.1007/s43477-022-00053-4.
    Résumé : Since the beginning of the COVID-19 pandemic in Africa, many epidemiological or anthropological studies have been published. However, few studies have yet been conducted to understand the implementation of State interventions to fight the COVID-19 pandemic. In Senegal, the national response plan was planned before the country experienced its first official case of COVID-19 on 2 March 2020. This qualitative study, conducted in March and April 2021, based on 189 interviews, aims to understand how the national response has been implemented in several regions of Senegal. Implementation of the response to the pandemic was favoured by good preparation, capacity to adapt, responsiveness of health actors, and commitment for both the political and religious authorities. The implementation response was confronted by several constraining factors such as the coercive approach, the challenges of coordinating actors, and the lack of intersectoral response. The central level has sometimes used reflexivity processes to adapt its response, but it has remained highly politicized, centralized, directive, and with little involvement of civil society. In Senegal, the response to the pandemic has been implemented in a relatively political and directive, even coercive manner, without necessarily considering prior knowledge and the need to adapt it to local contexts and to involve civil society and community actors in the process. In 2021, seroprevalence studies of SARS-CoV-2 (COVID-19) in Africa began to


  • Ridde Valéry, Guillard Étienne et Faye Adama (2022) « Le retour d’« une seule santé » et la santé mondiale : ne reproduisons pas les mêmes erreurs », MTSI, 2 (3) (juillet 18). DOI : 10.48327/mtsi.v2i3.2022.255. http://revuemtsi.societe-mtsi.fr/index.php/bspe-articles/article/view/255.
    Résumé : <p>La pandémie liée à la COVID-19 a fait redécouvrir le concept d’« une seule santé » et l’idée que l’animal, l’être humain et l’environnement sont intimement liés. Ce concept n’est pourtant pas nouveau, mais il reste labile, ce qui contribue à créer une certaine confusion. Dans la pratique, les actions de terrain manquent encore cruellement et « une seule santé » ne parvient pas à intégrer les trois dimensions. Cet éditorial vise ainsi à partager six défis que devra relever la mise en œuvre de l’approche « une seule santé » pour éviter les écueils d’autres initiatives de santé mondiale. Ainsi, les programmes dédiés à une seule santé ne pourront être pertinents et pérennes sans impliquer activement les communautés. En outre, ce déploiement implique une indispensable décolonisation de la santé, c’est-à-dire une remise en cause de la manière dont les programmes sont gouvernés, financés, formulés, mis en œuvre et évalués, avec et pour les personnes et pays concernés. Elle ne pourra se faire sans s’attaquer aux inégalités sociales de santé et aux enjeux de pouvoir. Cette approche pousse à interroger les modèles d’exploitation des ressources tant agricoles que naturelles. Penser « une seule santé » implique de penser les problématiques et les interventions dans une perspective tant intersectorielle, inclusive et participative qu’interdisciplinaire, sinon transdisciplinaire et d’appréhender la complexité qui en résulte. Enfin, il conviendra de prendre en compte l’utilisation des résultats des recherches pour construire les actions et les politiques publiques. Prendre en compte ces différents défis et s’inscrire dans une perspective systémique et interdisciplinaire ancrée dans des contextes locaux selon une démarche participative et inclusive nous paraît ainsi essentiel pour répondre de manière appropriée, pertinente et durable aux enjeux associés à « une seule santé ».</p><p><strong>The comeback of “One Health” and global health: let us not make the same mistakes again</strong></p><p>The COVID-19 pandemic has led to a rediscovery of the concept of “One Health” and the idea that animals, humans and the environment are intimately linked. This is not a new concept, but it is still labile, contributing to inevitable confusion. There is still a lack of action on the ground, and “One Health” fails to integrate all three dimensions. This editorial aims to share six challenges for implementing the “One Health” approach in order to avoid the pitfalls of other global health initiatives. One Health programmes cannot be relevant and sustainable without the active involvement of communities. This deployment implies the necessary decolonisation of health, i.e. a rethinking of how programmes are governed, financed, formulated, implemented and evaluated, with and for the citizens and countries concerned. It cannot be done without addressing social inequalities in health and power issues. This approach leads to questioning the exploitation models of both agricultural and natural resources. Thinking about “One Health” implies thinking about issues and interventions from an intersectoral, inclusive and participatory perspective, from an interdisciplinary, if not transdisciplinary perspective, and understanding the resulting complexity. Finally, research findings should be taken into account to build public actions. Considering these different challenges and adopting a systemic and interdisciplinary perspective anchored in local contexts according to a participatory and inclusive approach thus seems essential to us to respond in an appropriate, relevant and sustainable manner to the issues associated with “One Health”.</p>


  • Ridde Valery et Hane Fatoumata (2022) « Invariants historiques des défis de la santé communautaire face aux urgences en Afrique (Commentaire) », Sciences sociales et santé, 40 (3) (septembre 1), p. 29-37. DOI : 10.1684/sss.2022.0230. https://www.cairn.info/revue-sciences-sociales-et-sante-2022-3-page-29.htm.
    Mots-clés : ⚠️ Invalid DOI.


  • Ridde Valéry, Kane Babacar, Gaye Ibrahima, Ba Mouhamadou Faly, Diallo Amadou, Bonnet Emmanuel, Traoré Zoumana et Faye Adama (2022) « Acceptability of government measures against COVID-19 pandemic in Senegal: A mixed methods study », éd. par Yodi Mahendradhata, PLOS Global Public Health, 2 (4) (avril 25), p. e0000041. DOI : 10.1371/journal.pgph.0000041. https://dx.plos.org/10.1371/journal.pgph.0000041.
    Résumé : While the first case of COVID-19 was declared on March 2 2020 in Senegal, the government banned the attendance of places of worship on 14 March, as a first measure. On March 23, it introduced a curfew, a ban on movement between regions, and the closure of markets. The objective of this study is to measure and understand the acceptability of these four governmental measures as well as the level of public trust in the state to fight the pandemic. We carried out a mixed-method research. The acceptability variables were defined using the theoretical framework of acceptability (TFA). At the quantitative level, we carried out a telephone survey (June/July 2020) at the national level (n = 813) with a sampling strategy by marginal quotas. We conducted a qualitative survey (August/September 2020) with a nested sample (n = 30). The results show a relatively high acceptability of the measures but a heterogeneity of responses. People considered curfews to be much more important (85.7% [83.2%; 88.0%]) than the closure of places of worship (55.4%; [51.9%; 58.7%]), which is least in line with the values and positive affective attitude. Several positive unintended effects of the curfew were stated (security and social/family cohesion). People over the age of 60 have more confidence in the government to fight the pandemic than people under the age of 25, although not significant (7.72 ± 3.12 vs. 7.07 ± 3.11, p = 0.1); and they are more in favour of the closure of places of worship. The more regions are affected by the pandemic, the less confidence respondents report in the government and the less they perceive the measures as effective. The results confirm the importance of government communication and trust in the state to strengthen the acceptability of pandemic measures. Important differences in acceptability show the need to adapt measures and their explanations, instead of unqualified universal action.

  • Ridde Valéry, Kane Babacar, Mbow Ndeye Bineta, Senghor Ibrahima et Faye Adama (2022) Résilience de deux unités départementales d'assurance maladie face à la pandémie de COVID-19 au Sénégal (3), Paris, France : Ceped. (Document de travail Unissahel). https://doi.org/10.5281/zenodo.7006810.
    Résumé : Introduction : Dans sa recherche de solutions pour la couverture universelle en santé, le Sénégal a mis en place, en parallèle des mutuelles de santé communautaire communale, deux unités d’assurance maladie professionnelle départementale (UDAM) depuis 2014. Peu d’études sur la résilience des systèmes de santé en Afrique se sont encore penchées sur celle des assurances de santé. L’objectif de cet article est de comprendre comment ces deux UDAM ont été résilientes à la pandémie de COVID-19 et aux mesures restrictives imposées par l’État afin de maintenir les services à leurs membres et les remboursements aux prestataires de soins. Méthodes : La stratégie méthodologique est celle d’une étude de cas multiples avec plusieurs niveaux d’analyse au moyen d’un cadre conceptuel de la résilience et de l’analyse des configurations organisationnelles. Les données empiriques proviennent d’analyse de la documentation, d’observations dans les deux UDAM durant six mois et de 17 entretiens qualitatifs en profondeur auprès d’un échantillon de personnes sélectionnées en fonction de leur connaissance approfondie du fonctionnement et repérées lors d’une étude exploratoire. Résultats : Les résultats ont permis d’identifier trois configurations principales concernant i) la sécurité et l’hygiène, ii) l’organisation et la planification, iii) la communication pour le maintien du paiement. L’analyse de ces configurations montrent que les UDAM ont fait face à la pandémie, parfois en innovant (digitalisation), afin d’absorber le choc et de maintenir les services à leurs membres. Elles ont même contribué aux actions de lutte contre la pandémie dans leurs régions. Les UDAM ont tiré des leçons favorables de cette gestion de crise comme pour le travail à distance ou la capacité de soutenir les adhérents dans leur parcours de soins au sein des hôpitaux éloignés de leur siège. Elles ont innové avec l’organisation du paiement électronique et l’usage des réseaux sociaux pour collecter les fonds et communiquer avec les adhérents. Conclusion : Les deux UDAM ont montré qu’elles avaient été en mesure de s’adapter aux chocs de la pandémie et des mesures gouvernementales pour le maintien des services de leurs membres et de leur routine organisationnelle. Le renforcement de leur efficacité après le choc du départ de leur principal bailleur de fonds en 2017 a participé à l’adaptation, voire la transformation, à ce choc épidémique de 2020 et 2021.

  • Ridde Valéry, Kane Babacar, Mbow Ndeye Bineta, Senghor Ibrahima et Faye Adama (2022) La pérennité de deux mutuelles de santé départementales au Sénégal : une étude qualitative (7, Octobre 2022), Paris, France : Ceped. (Document de Travail Unissahel). https://doi.org/10.5281/zenodo.7194801.
  • Ridde Valéry et Olivier de Sardan Jean-Pierre (2022) « The Development World: Conflicts of Interest at All Levels », Revue internationale des études du développement, 249 (2), p. 247-269.


  • Rikap Cecilia (2022) « Becoming an intellectual monopoly by relying on the national innovation system: the State Grid Corporation of China's experience », Research Policy, 51 (4) (mai), p. 104472. DOI : 10/gn4dhg. https://linkinghub.elsevier.com/retrieve/pii/S004873332100264X.
    Résumé : This paper examines the origins of global leaders under intellectual monopoly capitalism. State Grid Corporation of China (SGCC), the leading firm in artificial intelligence applications for the energy sector, became an intellectual monopoly relying heavily on China's national innovation system –particularly public research organizations and public funding, and innovation and energy policies. SGCC is unique because it did not rely on technology transfer from global leaders, unlike other national champions from developing or emerging countries. We provide evidence that contributes to thinking that SGCC first became a national intellectual monopoly and only afterwards expanded that monopoly globally. We empirically study SGCC's innovation networks. We proxy them using big data techniques to analyze the content, co-authors and co-owners of its publications and patents. Results also suggest that SGCC is capturing intellectual rents from its increasingly transnational and technologically diverse innovation networks by leveraging its national innovation system.


  • Robert Emilie, Zongo Sylvie, Rajan Dheepa et Ridde Valéry (2022) « Contributing to collaborative health governance in Africa: a realist evaluation of the Universal Health Coverage Partnership », BMC Health Services Research, 22 (1) (décembre), p. 753. DOI : 10.1186/s12913-022-08120-0. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08120-0.
    Résumé : Abstract Background Policy dialogue, a collaborative governance mechanism, has raised interest among international stakeholders. They see it as a means to strengthen health systems governance and to participate in the development of health policies that support universal health coverage. In this context, WHO has set up the Universal Health Coverage Partnership. This Partnership aims to support health ministries in establishing inclusive, participatory, and evidence-informed policy dialogue. The general purpose of our study is to understand how and in what contexts the Partnership may support policy dialogue and with what outcomes. More specifically, our study aims to answer two questions: 1) How and in what contexts may the Partnership initiate and nurture policy dialogue? 2) How do collaboration dynamics unfold within policy dialogue supported by the Partnership?  Methods We conducted a multiple-case study realist evaluation based on Emerson’s integrative framework for collaborative governance to investigate the role of the Partnership in policy dialogue on three policy issues in six sub-Saharan African countries: health financing (Burkina Faso and Democratic Republic of Congo), health planning (Cabo Verde, Niger, and Togo), and aid coordination for health (Liberia). We interviewed 121 key informants, analyzed policy documents, and observed policy dialogue events. Results The Partnership may facilitate the initiation of policy dialogue when: 1) stakeholders feel uncertain about health sector issues and acknowledge their interdependence in responding to such issues, and 2) policy dialogue coincides with their needs and interests. In this context, policy dialogue enables stakeholders to build a shared understanding of issues and of the need for action and encourages collective leadership. However, ministries’ weak ownership of policy dialogue and stakeholders’ lack of confidence in their capacity for joint action hinder their engagement and curb the institutionalization of policy dialogue. Conclusions Development aid actors wishing to support policy dialogue must do so over the long term so that collaborative governance becomes routine and a culture of collaboration has time to grow. Public administrations should develop collaborative governance mechanisms that are transparent and intelligible in order to facilitate stakeholder engagement.


  • Cicchelli Vincenzo et Octobre Sylvie (2022) « Unpacking youth cosmo-cultures: global pop culture and the example of its Korean glocalization », in Handbook of Culture and Glocalization, éd. par Victor Roudometof et Ugo Dessì, Edward Elgar Publishing, p. 371-385. ISBN : 978-1-83910-901-0 978-1-83910-900-3. https://www.elgaronline.com/view/book/9781839109010/book-part-9781839109010-32.xml.

  • Rouveau Nicolas, Ky-Zerbo Odette, Boye Sokhna, Simo Fotso Arlette, d'Elbée Marc, Maheu-Giroux Mathieu, Silhol Romain, Kouassi Arsène Kra, Vautier Anthony, Doumenc-Aïdara Clémence, Breton Guillaume, Keita Abdelaye, Ehui Eboi, Ndour Cheick Tidiane, Boilly Marie-Claude, Terris-Prestholt Fern, Pourette Dolorès, Desclaux Alice, Larmarange Joseph et pour l'équipe ATLAS (2022) Décrire, analyser et comprendre les effets de l’introduction de l’autodépistage du VIH en Afrique de l’Ouest à travers l’exemple du programme ATLAS en Côte d’Ivoire, au Mali et au Sénégal, Working Papers du CEPED (52), Paris : Ceped, 26 p. https://www.ceped.org/wp.
    Résumé : Ce working paper est une traduction en français de l’article suivant : Rouveau N, Ky-Zerbo O, Boye S, Simo Fotso A, d’Elbée M, Maheu-Giroux M, Silhol R, Kouassi AK, Vautier A, Doumenc-Aïdara C, Breton G, Keita A, Ehui E, Ndour CT, Boilly MC, Terris-Prestholt F, Pourette D, Desclaux A, Larmarange J for the ATLAS Team. Describing, analysing and understanding the effects of the introduction of HIV self-testing in West Africa through the ATLAS programme in Côte d’Ivoire, Mali and Senegal. BMC Public Health. 2021, 21, 181. doi.org/10.1186/s12889-021-10212-1 Contexte : Le programme ATLAS vise à promouvoir et à déployer l’autodépistage du VIH (ADVIH) dans trois pays d’Afrique de l’Ouest : Côte d’Ivoire, Mali et Sénégal. Sur la période 2019-2021, en étroite collaboration avec les parte-naires nationaux de mise en œuvre de la lutte contre le sida et les communautés, ATLAS prévoit de distribuer 500 000 kits VIHST à travers huit canaux de distribution, combinant des stratégies fixes et des stratégies avancées, une distribution primaire et une distribution secondaire d’ADVIH. Tenant compte de l’épidémiologie ouest-africaine, les cibles du programme ATLAS sont les populations difficiles à atteindre : les populations clés (travailleuses de sexe, hommes ayant des rapports sexuels avec des hommes et usager·e·s de drogues), leurs clients ou partenaires sexuels, les partenaires des personnes vivant avec le VIH et les patients diagnostiqués avec des infections sexuellement transmissibles et leurs partenaires. Le programme ATLAS intégrer ainsi un volet recherche ayant pour objectif d’accompagner cette mise en œuvre et de générer des connaissances sur le passage à l’échelle de l’ADVIH en Afrique de l’Ouest. L’objectif principal est de décrire, d’analyser et de comprendre les effets sociaux, sanitaires, épidémiologiques et économiques de l’introduction de l’autodépistage du VIH en Côte d’Ivoire, au Mali et au Sénégal pour améliorer l’offre de dépistage (accessibilité, efficacité, éthique). Méthodes : La recherche ATLAS est organisée en cinq work packages (WP) multidisciplinaires : WP Populations clés : enquêtes qualitatives (entretiens individuels approfondis, discussions de groupe) menées auprès des acteurs clés, des populations clés et des utilisateurs des services de dépistage du VIH. WP Dépistage des cas index : observation ethnographique de trois services de soins VIH introduisant l’ADVIH pour le dépistage du partenaire. WP Enquête coupons : une enquête téléphonique anonyme auprès des utilisateurs de l’ADVIH. WP Volet économique : analyse des coûts économiques différentiels de chaque modèle de dispensation à l’aide d’une approche descendante avec collecte des coûts programmatiques, complété par une approche ascen-dante auprès d’un échantillon de sites de dispensations de l’ADVIH, et une étude temps-mouvement auprès d’un échantillon d’agent·e·s dispensateurs. WP Modélisation : adaptation, paramétrisation et calibration d’un modèle compartimental dynamique qui prend en compte les diverses populations ciblées par le programme ATLAS et les différentes modalités et stra-tégies de dépistage. Discussion : Le programme ATLAS est la première étude complète sur l’autodépistage du VIH en Afrique de l’Ouest. Le programme ATLAS se concentre particulièrement sur la distribution secondaire de l’ADVIH. Ce protocole a été ap-prouvé par trois comités d’éthique nationaux et par le comité d’éthique de la recherche de l’OMS. Mots-clés : VIH/SIDA, autodépistage du VIH, Afrique de l’Ouest, Sénégal, Côte d’Ivoire, Mali.
  • Rozée Virginie et Schantz Clémence (2022) « Turbulences, résistances et résiliences dans les maternités françaises », Colloque international présenté à Accoucher en temps de pandémie, juin 8, Campus Condorcet, Paris, France.
  • Rozée Virginie et Schantz Clémence (2022) « Les représentations de l’accouchement en France (en métropole et à la Réunion): ce que révèle la réorganisation des soins en obstétrique pendant la crise du COVID-19 », Journée d'étude présenté à Santé sexuelle et reproductive face aux crises : perspectives internationales, juin 14, Campus Condorcet, Paris, France.


  • Rudasingwa Martin, De Allegri Manuela, Mphuka Chrispin, Chansa Collins, Yeboah Edmund, Bonnet Emmanuel, Ridde Valéry et Chitah Bona Mukosha (2022) « Universal health coverage and the poor: to what extent are health financing policies making a difference? Evidence from a benefit incidence analysis in Zambia », BMC Public Health, 22 (1) (août 13), p. 1546. DOI : 10.1186/s12889-022-13923-1. https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13923-1.
    Résumé : Abstract Background Zambia has invested in several healthcare financing reforms aimed at achieving universal access to health services. Several evaluations have investigated the effects of these reforms on the utilization of health services. However, only one study has assessed the distributional incidence of health spending across different socioeconomic groups, but without differentiating between public and overall health spending and between curative and maternal health services. Our study aims to fill this gap by undertaking a quasi-longitudinal benefit incidence analysis of public and overall health spending between 2006 and 2014. Methods We conducted a Benefit Incidence Analysis (BIA) to measure the socioeconomic inequality of public and overall health spending on curative services and institutional delivery across different health facility typologies at three time points. We combined data from household surveys and National Health Accounts. Results Results showed that public (concentration index of − 0.003; SE 0.027 in 2006 and − 0.207; SE 0.011 in 2014) and overall (0.050; SE 0.033 in 2006 and − 0.169; SE 0.011 in 2014) health spending on curative services tended to benefit the poorer segments of the population while public (0.241; SE 0.018 in 2007 and 0.120; SE 0.007 in 2014) and overall health spending (0.051; SE 0.022 in 2007 and 0.116; SE 0.007 in 2014) on institutional delivery tended to benefit the least-poor. Higher inequalities were observed at higher care levels for both curative and institutional delivery services. Conclusion Our findings suggest that the implementation of UHC policies in Zambia led to a reduction in socioeconomic inequality in health spending, particularly at health centres and for curative care. Further action is needed to address existing barriers for the poor to benefit from health spending on curative services and at higher levels of care.


  • Rudasingwa Martin, Yeboah Edmund, Ridde Valéry, Bonnet Emmanuel, De Allegri Manuela et Muula Adamson Sinjani (2022) « How equitable is health spending on curative services and institutional delivery in Malawi? Evidence from a quasi-longitudinal benefit incidence analysis », International Journal for Equity in Health, 21 (1) (décembre), p. 25. DOI : 10.1186/s12939-022-01624-5. https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-022-01624-5.
    Résumé : Abstract Background Malawi is one of a handful of countries that had resisted the implementation of user fees, showing a commitment to providing free healthcare to its population even before the concept of Universal Health Coverage (UHC) acquired global popularity. Several evaluations have investigated the effects of key policies, such as the essential health package or performance-based financing, in sustaining and expanding access to quality health services in the country. Understanding the distributional impact of health spending over time due to these policies has received limited attention. Our study fills this knowledge gap by assessing the distributional incidence of public and overall health spending between 2004 and 2016. Methods We relied on a Benefit Incidence Analysis (BIA) to measure the socioeconomic inequality of public and overall health spending on curative services and institutional delivery across different health facility typologies. We used data from household surveys and National Health Accounts. We used a concentration index (CI) to determine the health benefits accrued by each socioeconomic group. Results Socioeconomic inequality in both public and overall health spending substantially decreased over time, with higher inequality observed in overall spending, non-public health facilities, curative health services, and at higher levels of care. Between 2004 and 2016, the inequality in public spending on curative services decreased from a CI of 0.037 (SE 0.013) to a CI of 0.004 (SE 0.011). Whiles, it decreased from a CI of 0.084 (SE 0.014) to a CI of 0.068 (SE 0.015) for overall spending in the same period. For institutional delivery, inequality in public and overall spending decreased between 2004 and 2016 from a CI of 0.032 (SE 0.028) to a CI of -0.057 (SE 0.014) and from a CI of 0.036 (SE 0.022) to a CI of 0.028 (SE 0.018), respectively. Conclusions Through its free healthcare policy, Malawi has reduced socioeconomic inequality in health spending over time, but some challenges still need to be addressed to achieve a truly egalitarian health system. Our findings indicate a need to increase public funding for the health sector to ensure access to care and financial protection.


  • Rungreangkulkij Somporn, Ratinthorn Ameporn, Lumbiganon Pisake, Zahroh Rana Islamiah, Hanson Claudia, Dumont Alexandre, Loenzien Myriam de, Betrán Ana Pilar et Bohren Meghan A. (2022) « Factors influencing the implementation of labour companionship: formative qualitative research in Thailand », BMJ Open, 12 (5) (mai 1), p. e054946. DOI : 10.1136/bmjopen-2021-054946. http://bmjopen.bmj.com/content/12/5/e054946.abstract.
    Résumé : Introduction WHO recommends that all women have the option to have a companion of their choice throughout labour and childbirth. Despite clear benefits of labour companionship, including better birth experiences and reduced caesarean section, labour companionship is not universally implemented. In Thailand, there are no policies for public hospitals to support companionship. This study aims to understand factors affecting implementation of labour companionship in Thailand.Methods This is formative qualitative research to inform the ‘Appropriate use of caesarean section through QUALIty DECision-making by women and providers’ (QUALI-DEC) study, to design, adapt and implement a strategy to optimise use of caesarean section. We use in-depth interviews and readiness assessments to explore perceptions of healthcare providers, women and potential companions about labour companionship in eight Thai public hospitals. Qualitative data were analysed using thematic analysis, and narrative summaries of the readiness assessment were generated. Factors potentially affecting implementation were mapped to the Capability, Opportunity, and Motivation behaviour change model (COM-B).Results 127 qualitative interviews and eight readiness assessments are included in this analysis. The qualitative findings were grouped in four themes: benefits of labour companions, roles of labour companions, training for labour companions and factors affecting implementation. The findings showed that healthcare providers, women and their relatives all had positive attitudes towards having labour companions. The readiness assessment highlighted implementation challenges related to training the companion, physical space constraints, overcrowding and facility policies, reiterated by the qualitative reports.Discussion If labour companions are well-trained on how to best support women, help them to manage pain and engage with healthcare teams, it may be a feasible intervention to implement in Thailand. However, key barriers to introducing labour companionship must be addressed to maximise the likelihood of success mainly related to training and space. These findings will be integrated into the QUALI-DEC implementation strategies.Data are available on reasonable request. Data are available on reasonable request from the corresponding author.


  • Salje Henrik, Kyungah Lim Jacqueline, Ridde Valery, Todagbe Agnandji Selidji, Lell Bertrand, Yaro Seydou, Seung Yang Jae, Hoinard Damien, Weaver Scott, Vanhomwegen Jessica et Yoon In-Kyu (2022) « Seroepidemiological reconstruction of long-term chikungunya virus circulation in Burkina Faso and Gabon », Journal of Infectious Diseases (juin 15). DOI : 10.17863/CAM.85546. https://www.repository.cam.ac.uk/handle/1810/338137.
    Résumé : Chikungunya virus (CHIKV) is a major public health concern worldwide. However, infection levels are rarely known, especially in Africa. We recruited individuals from Ouagadougou, Burkina Faso and Lambaréné, Gabon (age range: 1-55), tested their blood for CHIKV antibodies and used serocatalytic models to reconstruct epidemiological histories. In Ouagadougou, 291/999 (29.1%) individuals were seropositive, ranging from 2% among those <10y to 66% in those 40-55y. We estimated there were 7 outbreaks since the 1970s but none since 2001 resulting in 600,000 infections in the city, none of which were reported. However, we could not definitively conclude whether infections were due to CHIKV or o’nyong-nyong, another alphavirus. In Lambaréné, 117/427 (27%) participants were seropositive. Our model identified a single outbreak sometime since 2007, consistent with the only reported CHIKV outbreak in the country. These findings suggest sporadic outbreaks in these settings and that the burden remains undetected or incorrectly attributed.
    Note Note
    <h2>Other</h2> European Research Council

  • Samadoulougou Sekou, Negatou Mariamawit, Ngawisiri Calypse, Ridde Valery et Kirakoya-Samadoulougou Fati (2022) « Effect of the free healthcare policy on socioeconomic inequalities in care seeking for fever in children under five years in Burkina Faso: a population-based surveys analysis », International Journal for Equity in Health, 21 (1) (septembre 1), p. 124. DOI : 10.1186/s12939-022-01732-2.
    Résumé : BACKGROUND: In 2016, Burkina Faso implemented a free healthcare policy as an initiative to remove user fees for women and under-5 children to improve access to healthcare. Socioeconomic inequalities create disparities in the use of health services which can be reduced by removing user fees. This study aimed to assess the effect of the free healthcare policy (FHCP) on the reduction of socioeconomic inequalities in the use of health services in Burkina Faso. METHODS: Data were obtained from three nationally representative population based surveys of 2958, 2617, and 1220 under-5 children with febrile illness in 2010, 2014, and 2017-18 respectively. Concentration curves were constructed for the periods before and after policy implementation to assess socioeconomic inequalities in healthcare seeking. In addition, Erreyger's corrected concentration indices were computed to determine the magnitude of these inequalities. RESULTS: Prior to the implementation of the FHCP, inequalities in healthcare seeking for febrile illnesses in under-5 children favoured wealthier households [Erreyger's concentration index = 0.196 (SE = 0.039, p = 0.039) and 0.178 (SE = 0.039, p < 0.001) in 2010 and 2014, respectively]. These inequalities decreased after policy implementation in 2017-18 [Concentration Index (CI) = 0.091, SE = 0.041; p = 0.026]. Furthermore, existing pro-rich disparities in healthcare seeking between regions before the implementation of the FHCP diminished after its implementation, with five regions having a high CI in 2010 (0.093-0.208), four regions in 2014, and no region in 2017 with such high CI. In 2017-18, pro-rich inequalities were observed in ten regions (CI:0.007-0.091),whereas in three regions (Plateau Central, Centre, and Cascades), the CI was negative indicating that healthcare seeking was in favour of poorest households. CONCLUSION: This study demonstrated that socioeconomic inequalities for under-5 children with febrile illness seeking healthcare in Burkina Faso reduced considerably following the implementation of the free healthcare policy. To reinforce the reduction of these disparities, policymakers should maintain the policy and focus on tackling geographical, cultural, and social barriers, especially in regions where healthcare seeking still favours rich households.
  • Sambou Césarine, Pourette Dolorès, DeBeaudrap Pierre, Raho-Moussa Mariem et Allavena Clotilde (2022) « «Avec le VIH, on ne parle pas de nos problèmes de santé » : secret et polypathologie chez les personnes vivant avec le VIH âgées de 70 ans et plus » (Poster PV332), présenté à AFRAVIH, Marseille.


  • Sauvegrain P, Schantz Clemence, Gaucher L et Chantry AA (2022) « Avenues for measuring and characterising violence in perinatal care to improve its prevention: a position paper with a proposal by the National College of French Midwives », Midwifery (octobre 26), p. 103520. DOI : 10.1016/j.midw.2022.103520. https://www.sciencedirect.com/science/article/pii/S0266613822002716.
    Résumé : Background France is somewhat behind other countries in its consideration of the issue of violence in perinatal care. Its consequences on maternal, but also neonatal and infant health are recognised internationally. Nonetheless, research and data measuring its frequency and its determinants are inadequate, and the relevant definitions are not always consensual. In this context, we, as midwives and researchers in public health and as members of the National College of French Midwives, seek to propose a scientific and clinical contribution to this debate. Aim We propose avenues for measuring and characterising violence in in perinatal care. Our objective is to quantify and characterise the situations of violence in perinatal care in population-based studies and based on the perceptions of each woman questioned. Discussion This proposal for questions, simplified compared with those currently in use in the international scientific literature, has the advantage of focusing reflection around three categories: inappropriate medical care, inappropriate human behaviours in care, and sexual abuse. It should also allow the identification of the contexts of care during which violence may be experienced, as well as the categories of health-care workers concerned. Conclusion It seems important to us to distinguish these situations, causal and context, for they require different responses if we hope to reduce the frequency and the effects of violence in perinatal care in the future. We propose questions that could also be used in clinical situations by midwives and other clinicians.
    Mots-clés : Classification, Observational studies, Obstetric care, Prevention, violence in perinatal care, Women's opinion.
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