[Factors associated with the practice of exclusive breastfeeding among mothers of children aged 6 to 12 months in Kaolack (Senegal)]. / Facteurs associés à la pratique de l´allaitement maternel exclusif chez les mères d´enfants âgés de 6 à 12 mois dans la commune de Kaolack (Sénégal).

Introduction: the World Health Organization (WHO) recommends immediate and exclusive breastfeeding in order to reduce malnutrition and neonatal mortality. The purpose of this study was to determine the prevalence of exclusive breastfeeding (EBF) and to identify its associated factors among mothers of children aged 6 to 12 months in Kaolack. Method: we conducted a cross-sectional descriptive and analytical study. The study was conducted from July 8th, 2020 to February 8th, 2021. Multivariate analysis was performed using the logistic regression model. The target population consisted of mothers of children aged 6 to 12 months residing in the city of Kaolack and met during vaccination sessions. Results: a total of 400 women were enrolled in the study. Among them, 51.8% practiced EBF according to the WHO recommendations. The average age of mothers was 27.42 years; 56.3% were housewives and 82.7% have done at least 4 antenatal care (ANC). Logistic regression showed an association between EBF and the following factors: age < 25 years (OR=2.03 CI 95% [1.23-3.36]), receiving advice on EBF during ANCs (OR=2.92 CI 95% [1.70-5.01]), receiving advice on EBF during postnatal care (PNC) (OR=4.33 CI 95% [2.51-7.45]), the permanent presence of mother with her baby (OR=3.97 CI 95% [1.99-7.91]), and a good knowledge of EBF (OR=4.54 CI 95% [1.96-10.51]). Conclusion: these modifiable factors can help improve the practice of EBF in the city of Kaolack.

[Study Of The Availability Of Medicine For Childhood In Senegal]. / Etude De La Disponibilite Des Medicaments Utilises Dans La Prise En Charge Therapeutique Des Enfants Ages De Moins De 5 Ans Dans La Region De Dakar Au Senegal.

INTRODUCTION: In Senegal, the main causes of death are the pneumonia, the diarrhea and the malaria. The malnutrition is an underlying factor in more than a third of the deaths, because it returns the more vulnerable children to the serious illnesses. The general objective of this research is to study the availability and the price of medicine in the therapeutic care of the children of less than 5 years old in the region of Dakar in Senegal. METHODOLOGY: Our study is of transverse, descriptive concerned the public sanitary, the wholesalers, the private pharmacies, The population of study concerns the old children at least of 5ans. The methods used were the interviews by means of questionnaire. RESULTS: The group of antibiotics, acid anti, antidotes, vitamins, diuretics, antiemetic's, and psychotropic were not available. As regards generic medicines, relatively low availability of 30,4 %, 23,8 % and 16,7 % is respectively observed in the public, private and denominational sectors. The availability of generic medicines in Dakar was from 81 % in the public sector and from 113 % in the private sector. CONCLUSION: The findings make it imperative for all other relevant medicine drugs in order to reduce the mortality rate.

INTRODUCTION: Au Sénégal, les principales causes de mortalitéchez les enfants de moins de 5ans sont la pneumonie, la diarrhée et le paludisme. La malnutrition est un facteur sous-jacent dans plus d'un tiers des décès, car elle rend les enfants plus vulnérables aux maladies graves. MÉTHODE: Notre étude est de type transversal, descriptif et a porté sur les formations sanitaires publiques les grossistes, les pharmacies privées, L'objectif général de cette recherche est d'étudier la disponibilité et le prix des médicaments dans la prise en charge thérapeutique des enfants âgés de moins de 5 ans dans la région de Dakar au Sénégal. La méthode utilisée était des questionnaires et entrevues. RÉSULTATS: Le groupe des antibiotiques, des anti acides, des antidotes, des vitamines, des diurétiques, des antiémétiques et des psychotropes n'étaient pas disponibles. Concernant les médicaments génériques, des disponibilités relativement faibles de 30,4 %, 23,8% et 16,7% sont respectivement observées dans les secteurs public, privé et confessionnel. La disponibilité des médicaments génériques à Dakar était de 81% dans le secteur public et de 113% dans le secteur privé. CONCLUSION: Les résultats prouvent l'impérieuse nécessité de rendre disponibles les médicaments pédiatriques si nous voulons réduire la mortalité des enfants de moins de 5ans.

Facteurs d'adhésion et utilisation des Mutuelles de Santé (MS) : région Ziguinchor au Sénégal.

AIM: The purpose of this article is to identify, the factors that would explain the adherence and use of MS and make recommendations for actions that would encourage the population to adhere more at the MS in the Ziguinchor region in Senegal. METHOD: The sample was concerned by 392 patients selected by the quota method in the hospitals of the region. The data were processed and analyzed by the sphinx and stata software through the logistic regression method. RESULTS: The factors that would explain the adherence and use of MS in the study area were: perception, the presence of an elderly person in the household, confidence in MS, household size and the pyramid medical institution.

[Membership factors and use of mutual health insurance in the Ziguinchor region of Senegal]. / Facteurs d'adhésion et utilisation des Mutuelles de Santé (MS) : région Ziguinchor au Sénégal.

AIM: The purpose of this article is to identify, the factors that would explain the adherence and use of MS and make recommendations for actions that would encourage the population to adhere more at the MS in the Ziguinchor region in Senegal. METHOD: The sample was concerned by 392 patients selected by the quota method in the hospitals of the region. The data were processed and analyzed by the sphinx and stata software through the logistic regression method. RESULTS: The factors that would explain the adherence and use of MS in the study area were: perception, the presence of an elderly person in the household, confidence in MS, household size and the pyramid medical institution.

Analysis of public policies in favor of the elderly people in Senegal: state of legal protection.

Senegal will be spared by phenomenon of population ageing, which will surely have socioeconomic and cultural consequences that will not be easy to tackle, as all sectors will be affected. In regard to legal protection, there are not any special legal acts for the elderly as is the case for children and women. They are treated just as responsible adults whose legal status is the same as everyone else. As far as the framework of legal protection of elderly people is concerned, Senegal has ratified all international and regional means and mecanisms for the protection of the rights of the elderly. In addition, the authorities have adopted policies and programs that favor taking charge of old people's interests. At the present, Senegal possesses a legal framework for the protection of its elderly people. So the matter is about creating new rights, because even the existing rights are not known to their beneficiaries. What is important is to ensure that the elderly fully enjoy their rights in the same way as the other members of society. It is wise, therefore, to put in place plan for information, public awareness and communication concerning the legal regulating framework. Thus, Senegal could be regarded as a pioneer in terms of the protection the elderly, and these leading programs can represent models for the countries of the region, whose social, sanitary and economic contexts are similar.

[Evolution of Community engagement in the fight against Ebola]. / Évolution de l'implication des communautés dans la riposte à Ebola.

CONTEXT: Community engagement is one of the most effective approaches to the fight against Ebola. It has been shown to be effective in other contexts and was implemented in Guinea for two years to reduce the spread of the Ebola Outbreak. METHODS: This article is based on a qualitative approach combining several data collection methods over a nine-month period in the field : series of formal and informal interviews, participating observations, focus groups, comment meetings, analysis of reports and follow-up of news on the Ebola Outbreak. These methods are designed to more effectively describe community engagement in the fight against Ebola in Guinea. RESULTS: Communities were initially subjected to coercive methods of prevention and control of Ebola and were stigmatized. This context subsequently led to two forms of resistance from communities in relation to the actors of prevention : passive and active resistance. The course of the epidemic and the determination of the mediators finally succeeded in involving the communities in the fight against Ebola, which therefore effectively contributed to the end of the epidemic. DISCUSSION: These results demonstrate that, as during other epidemics and in other contexts, communities are not passive stakeholders in the fight against Ebola. They can be actively involved based on their knowledge, but also the attitudes of other actors involved in the fight against VME.

Elderly and preventive care of the geriatric pathologies in African environment.

Senegal will not be spared by the process of the aging of its population. In fact, according to surveys, the demographic increase in the population of the old people, which is 3.5% higher than the national average (2.5%). But for the time being, gerontology problems are not arising in terms of demographic weight, but rather in terms of the breaking up of solidarity networks, uncontrolled urbanization and poverty. As far as health is concerned, the old people generally are faced with the same problems as their Northern counterparts; they are exposed to chronic diseases that demand their taking in charge in a long period of time. Besides, these diseases are a great handicap and they are also disabling diseases. So taking them in charge puts a financial on their meager family budgets or their pensions. In addition, there are no specialists in geriatrics, and those working in the field did not receive any training for that. Moreover, most of our health facilities are lacking in diagnostic means. Therefore, gerontology-geriatrics solutions that are adapted to our socio-economic context should be assigned straight away. The problem is not about stopping the process of aging, which, as a physiological process, is inevitable and irreversible, but rather delaying its effects. The matter at issue will be about how to set up a decentralized and integrated program that is designed to fight against geriatric diseases and disorders and that mainly focuses on screening and primary and secondary prevention, for our low financial resources and the low medical equipment of our health facilities cannot help us to adequately take charge of complications related to these diseases.

[Sesame Health Programme at Senegal: Limitations of this free healthcare model]. / Plan Sésame au Sénégal : limites de ce modèle de gratuité.

INTRODUCTION: Up until now, elderly people have experienced medical management difficulties despite the free care provided by the Sesame Health Programme. The objective of this study was to determine the costs borne by beneficiaries and/or their families and to evaluate these costs in relation to overall management. This comprehensive, cross-sectional, quantitative study was conducted from 21 February to 21 March 2011 in the Ouakam gerontology centre. METHODS: Epi Info Version 6 software was used for data analysis. The study population was composed of 203 patients with a mean age of 68 years, with 59% of women and 63% of retired subjects. The most common diseases were hypertension (52%), cataract (16%), and osteoarthritis (12%). RESULTS: The beneficiaries healthcare costs were covered by the Sesame Health Programme, apart from most of the drugs used to treat chronic diseases, which remained at the charge of patients and/or their families. The overall mean cost of monthly management of the diseases detected in elderly people was estimated to be CFA 37,700, a large share of which (65%) was supported by the patient and/or the family corresponding to the purchase of these drugs. Other dysfunctions were also observed, particularly the difficulty of targeting beneficiaries, generic stock shortages, absence of generics for the treatment of chronic diseases. CONCLUSION: Recommendations are formulated to improve implementation of the Sesame Health Programme.

[Living the aging in Senegal Perceptions/representations and coping strategies of persons of age three: results of investigations retrospective]. / Vivre le vieillissement au Sénégal Perceptions/représentations et stratégies d'adaptation des personnes du troisième âge : résultats d'enquêtes rétrospectives.

In Senegal, due to the young age of the population (60%) the concerns of the old tend to be put in the background. And yet, problems related to old age are a reality. These problems come up not in terms of demography (the old represent only 4.7% of the population), but in terms of the breaking-up of the social fabric, urbanization and the dismantling of the solidarity and poverty networks. This work is based on a collection of qualitative data from three studies conducted between 2008 and 2011 with the elderly to assess their real- life experiences, their perception of aging, their challenges and coping strategies. The results showed a transformation in the role and status of the old; this transformation being caused by social and society-related mutations. As a result, the inter-generation solidarity links have much loosened in the urban areas making the old people more vulnerable (in economic, social, health terms), especially those in charge of a family. The situation has been made worse by the unemployment affecting their offspring. In addition, the old people, who are often suffering from chronic diseases, find it hard to take charge of their medical expenses, despite the institution of the National Sesame Health Plan for the old or free health care policy. This has made them even more vulnerable. Yet before this precarious situation, the elderly develop strategies to cope with difficulties. Some recommendations have been made with a view to improving their lives and socioeconomic condition.

["Good intentions are not enough": analysis of a health policy for the elderly in Senegal]. / "les bonnes intentions ne suffisent pas": analyse d'une politique de santé pour les personnes agées au sénégal.

In 2006, the Senegalese government introduced the "Plan Sésame", an unprecedented policy in West Africa aimed at reducing social vulnerability among the elderly (i.e. people aged over 60 years). This paper examines the process of implementation of the "Plan Sdsame': Using a qualitative approach, the study was based on a unique case study authorized by the Senegalese Ministry of Health. Three methods were used: i) individual interviews (n = 19), ii) discussion groups (n = 24), and iii) documentary study. Despite its social objective, the "Plan Sésame" was ultimately limited to free health care. However, even the health component of the plan has suffered from under funding. Political obstacles, inadequate accompanying measures and short staffing have resulted in late reimbursements at a local level, thus limiting the implementation of the plan. While both health professionals and elderly people are in favor of free healthcare, they are also critical of the implementation issues surrounding the "Plan Sésame": Although it appears to be a viable solution, these issues may spell the end of the plan. The task of designing solid technical foundations and developing appropriate accompanying measures should not be overlooked because of the limited interest of international partners in the "Plan Sésame" the national dimension of the plan and its electoral importance.