[Quality of health services in hospital nurseries in commune II of the district of Bamako]. / Qualite des procedures de soins infirmiers dans les formations sanitaires de la commune II du District de Bamako.

Despite the tremendous efforts undertaken by the government of Mali, health indicators for morbidity and mortality are still high. The global mortality rate of 13 per thousand and the low life expectancy are the main enhancing factors for such phenomenon. This study was undertaken in public, private and Para-public and community health structures as well as confessional and faith-based health organizations in commune II of the district of Bamako. Our evaluation was based on the Avedis Donavedian method for health services quality. It was a transversal study based on nursery care in the structures above cited. The procedures for this study consisted of passive observance of nursery care with retrospective collection of data on the technical practices of the health workers in the services offered. The results showed a higher deficit in term of incomplete technical practice, physical and psychic respect of patients in faith-based organizations than in other health structures. There were no written guidelines for preventing nosocomial infections, injections security, management of waste and hazards, prevention and treatment of wounds. There was a lack of adapted sterilization materials in most of the CSCOM and private structures. Most of the injections and treatment of wounds were done by assistant nurses and midwives. Moreover, the utilization rate of nonsterile syringes and pins between 5.3 and 13.6% in the population studied. In conclusion, there is no security in nursery care in most of the health structures of the Commune II in the district of Bamako.

[Role of men in family planning decisions in Mali]. / Implication des hommes dans la prise de decision concernant le planning familial au Mali.

The birth control program was in place and functional since 1970, and it was integrated with maternal and infant health activities in 1978: knowledge about contraception is increasing among women and men respectively 75.6% and 87.6% according to EDSM II, 2001. Nevertheless, only 5.7% of women and 10% of men reported the use of one of the modern contraceptive methods. This is a transversal descriptive and analytic study which included men of 14 years old and above residing in Kayes, Koulikoro, Mopti, Sikasso and Bamako. We used a random choice of 6 out of the 9 regions in Mali (Bamako and the 5 regions supported by partners funding the present study) followed by a non-random choice at different degrees. Data were uniformly collected from One thousand and four men. The mean age was 37.6 +/- 15.6 years, 44.7% of the men were monogamous whereas 23.1% were polygamous and 30.6% were either single or had a fiancé. Most of the men in the study group had more than 2 children compared to 34.2% without children and 19.9% with either one or two children. Among them, 89.1% reported to have heard about birth control program and 70.3% had listed Planned Parenthood as an objective of birth control. The most used methods of birth control the most used are contraceptives (66.7%), condoms (60.5%) and injections (30.8%). However, only 30.6% of men used one birth control method with their partners; among those studied in the cohort, 40.8% used birth control method with their wives. Condom was the main method used by 86% of the men compared to utilization of contraceptive pills and injections respectively 66.7% and 25.6%. Birth control methods were used mainly to protect against sexually transmitted diseases (20.7%), then maternal and infant health respectively 6.0% and 5.8%. 60.7% of men think that the decision to use birth control method should be made by them whereas 25.7% think that the decision should be made by the couples. Many strategies are being proposed to involve men in the wider implementation of birth control program; these strategies will be more efficient when the age group 20-29 and 30-44 are targeted nationwide including rural areas, as well as couples especially those polygamous and illiterate.