[Working in underserved areas in Côte d'Ivoire: motivation of students and healthcare professionals.] / Travailler en zones mal desservies en Côte d'Ivoire : motivation des étudiants et personnel de santé.

INTRODUCTION: The shortage and poor distribution of the Health Workforce in Ivory Coast remains a major challenge for government authorities. The aim of this study was to identify factors related to healthcare workers' preferences for job posting in underserved areas. METHODS: The Discrete Choice Experiment method was used. The survey was conducted during the months of August and September 2015 among 490 students in healthcare worker training programmes and 574 in-service healthcare workers randomly selected from 8 health regions of Ivory Coast. The mixed logit model was used for data analysis. RESULTS: Availability of safe drinking water, electricity, phone network, and internet connexion (p = 0.001), availability of regular transportation (p < 0.001), family proximity (p < 0.001) were the most important job attributes for accepting job posting in underserved areas for in-service medical officers, nursing officers, and midwives.The main factors for accepting job posting in underserved areas by students in medical training programmes (medical school, nursing and midwifery school) were the availability of a scholarship after 5 years of employment (p = 0.009), the availability of safe drinking water, electricity, phone network, and internet connexion (p = 0.001), and availability of regular transportation (p < 0.001). Various combinations of these attributes with a financial bonus of 20% of the current salary would increase the proportion of health workers willing to work in underserved areas. CONCLUSION: These results could help to elaborate effective strategies for the attraction and maintenance of healthcare workers in underserved areas in Ivory Coast.

[Abortion practices in high school students in Yamoussoukro, Côte d'Ivoire]. / Pratiques d?avortement chez des lycéennes à Yamoussoukro, Côte d?Ivoire.

INTRODUCTION: Induced abortion is illegal in Cote d'Ivoire, except when the mother's life is in danger. The primary objective of this study was to describe abortion practices among Yamoussoukro high school students. More specifically, this study estimated the prevalence of induced abortion, described the pathway and the methods used for abortion and determined any abortion-related complications. MATERIAL AND METHODS: This cross-sectional study was conducted in July 2011 on 312 randomly selected girls attending the Lycée Jeunes Filles in Yamoussoukro. RESULTS: These girls had a mean age (SD) of 16.1 (4.7) years; 258 (82.7%) of them had already had sexual intercourse and 81 (31.4%) had already been pregnant. Fifty (61.7% [56.3-67.1%]) of these 81 girls had already had an abortion. The abortion pathway was as follows: the main method was self-prescribed medication (70%) as first attempt, followed, in case of failure, by traditional healers (56.4%). Healthcare practitioners were usually consulted at the third attempt (85.7%). The most commonly used methods of abortion were drugs (91.9%), ingestion of plants/beverages (68.5%) and introduction of devices into the uterine cavity (62.3%). Twenty-two (44%) out of 50 induced abortions resulted in complications, mostly infectious complications (81.8%), and bleeding (68.2%). Complications were significantly associated with self-induced abortions or abortions performed by traditional healers (p < 0.001). CONCLUSION: More intensive sexual education, access to modern methods of contraception, awareness campaigns concerning the risks related to unwanted pregnancies and abortions performed by non-medical personnel need to be implemented to prevent school abortions. The quality and accessibility of post-abortion services also need to be reinforced.

Acceptability of the Kangaroo Mother Care at the University Hospital of Treichville in Côte d'Ivoire.

Background: Kangaroo Mother Care (KMC) is a low-tech, highimpact intervention for preterm and low-birth-weight newborns. In 2019, Côte d'Ivoire opened its first KMC unit. We wanted to determine KMC's acceptability in Côte d'Ivoire after a year. Methods: This qualitative study used semi-structured interviews in September 2020 at the Teaching Hospital of Treichville's first KMC unit. Mothers of preterm and low birth weight babies who received KMC were studied. Deductive (TFA-driven) framework analysis was performed. Coded using Nvivo 12. Results: KMC was acceptable overall. Mothers knew KMC's goal and benefits, including self-confidence and breastfeeding benefits. Most women reported that the method was easy to implement and were confident in implementing KMC at the unit or in the household, even though some of them found KMC not aligned with their cultural values. Some mothers, especially housewives and self-employed, highlighted the benefits of KMC, but they must have given up. Conclusions: Our study highlighted the need to increase KMC awareness, advocacy, education, and training for pregnant women and the community to reduce preterm and low birth weight infant mortality and morbidity.