Assessment of Staffing Needs for Frontline Health Workers in Selected Maternal and Child Health Services in 3 Countries of Sub-Saharan West Africa: Cote d'Ivoire, Burkina Faso, and Niger.

Sub-Saharan African countries health systems are generally faced with shortages and inequitable distribution of qualified health workers. The application of provider-population ratio or fixed staff establishments, not considering variation in workload, given contextual variations in service utilization rates, cannot adequately match the human resource needs of different health facilities. The Workload Indicators of Staffing Need (WISN) method uses workload to determine staffing needs in a given facility. The aim of this study was to assess the current workload and staffing needs of maternal and child health services in 12 primary healthcare facilities from Burkina Faso, Niger, and Cote d'Ivoire. We employed the WISN methodology, using document reviews, in-depth interviews with health providers, and observations, to obtain the data needed for estimating the required number of staff in a given facility. Then, we calculated both the WISN difference (current-required staff), and the WISN ratio (current staff/required staff). Using the WISN ratio, we assessed the work pressure that health workers experience. The results showed a shortage of health workers in most services in Cote d'Ivoire and Niger (WISN ratio <1), in contrast to Burkina Faso where services were either adequately staffed or overstaffed (WISN ratio ⩾1). The workload pressure was generally high or very high in Cote d'Ivoire, while in Niger, it was very high in maternity services but rather low in dispensary ones. There was also a geographic discrepancy in health workers staffing, rural areas services being more understaffed, with a higher workload pressure as compared to urban areas ones. This study results strengthens the body of knowledge on the shortage of health workforce in sub-Saharan Africa French speaking countries. Policies and strategies to increase students training capacities and the application of regular WISN studies for a better staff distribution are necessary to address the human resource needs of health facilities in these countries.

Epidemiologic Profile of Overweight and Obesity in Abidjan, Ivory Coast: A Cross-Sectional Study.

Background: In sub-Saharan Africa, the prevalence of overweight and obesity is high, and it is estimated to increase within the next ten years. In Ivory Coast, the rise in and public health consequences of overweight and obese people are evident. Moreover, data concerning this status are scarce, old, local, and describe only a small sample of the population. Objective: This study has been conducted in order to describe the epidemiologic profile of overweight and obese people in Ivory Coast and identify the potential risk factors of obesity. Methods: From January 2014 to July 2017, 2,643 patients aged 17-70 years old from Abidjan of Ivory Coast were recruited. Statistical analysis was carried out using SPSS 20.0. Chi-square test and binary logistic regression analysis were used to identify risk factors for overweight and obesity. Results: Most of our patients were females (86.3%) with an estimated average age of 43.7 ± 12.19 years. Among 2,643 patients recruited in this study, 83.3% were obese and 87.2% were affected by central abdominal obesity. Binary logistic regression analysis identified seven factors significantly associated with overweight and obesity, including females (OR: 2.06; 95% CI [1.58-2.68]), >54 years old of age (OR: 3.71; 95% CI [1.84-7.50]), occupation of salesperson and traders (OR: 2.42; 95% CI [1.78-3.29]), ethnic group of North Mande ethnicity (OR: 1.47; 95% CI [1.07-2.02]), family history of obesity (OR: 1.96; 95% CI [1.46-2.63]), ≥150 minutes of sport practice (OR:0.72; 95% CI [0.55-0.96]), and parous females (OR: 1.63; 95% CI [1.11-2.38]). Conclusions: Overall, gender (female), older age, and occupation were associated with greater risks of overweight and obesity in patients. Ethnic group, pregnancy and family history of obesity posed a lower but significant risk for obesity. More sport practice played a protective role against the acquisition of overweight and obesity.

[Quality of emergency obstetric care in Abidjan]. / Qualité de l'offre des Soins Obstétricaux d'Urgence (SOU) dans le district autonome d'Abidjan, Côte d'Ivoire.

This study aims to assess the quality of emergency obstetric care in 69 health facilities in Abidjan. The results show lethality was evaluated at 1.7 deaths out of 100 complications that received treatment. Obstetrical complications are largely dominated by the presence of bleeding, accounting for 36.1% of cases. Only 60.1% of emergency obstetric cases were fully covered and completely treated. Caesarian sections are rarely done (3.6%). The ratio of availability of comprehensive emergency obstetric care is poor (.79 for 500,000). Mobilization of all levels of actors in the health system is necessary to lead to any significant improvement in the current situation.