Knowledge and practice of health workers on sexual and reproductive health and rights and gender-based violence: Evidence from three municipalities in Senegal.

Adolescents in low- and middle-income countries face numerous developmental, sexual and reproductive health (SRHR) challenges, including exposure to multidimensional violence. Dealing with gender-based violence (GBV) is of great importance and health personnel are key players. The objective of this work was to study the knowledge and practices of health personnel on SRHR and gender-based violence in Guédiawaye, Kaolack and Kolda communities in Senegal. A descriptive and analytical cross-sectional study was conducted, which consisted of health professionals (general practitioners and specialists, nurses, and midwives) and community health workers (community relays, bajenu gox, matrons). All health facilities in the three communities were included. Data analysis consisted of univariate analysis and logistic regression modeling to investigate the factors associated with the knowledge and practice of health personnels. An alpha risk of 5% was taken. A total of 78 health professionals and 128 community actors were included in the study. More than half of the health personnel (56.3%) had good knowledge of policies, standards and protocols relating to sexual and reproductive health services for women (adolescents) and about 60% on conventions and laws. The level of knowledge was good among 51% of respondents and good practices among 54.9%. The factors associated with good knowledge were the municipality in which the profession was practiced, and the effects of training received in the social construction of gender. The factors associated with the practices were knowledge of policies, standards and protocols through training, training received in the provision of family planning services, and in medico-psychosocial management of cases of sexual violence. We conclude that the knowledge of stakeholders (health professionals and community health workers) about sexual and reproductive health and gender-based violence is important for better service provision and good management of cases of gender based violence.

Les adolescents des pays à revenu faible et moyen (PRFM) sont confrontés à de nombreux défis en matière de développement, de santé sexuelle et reproductive (SSR), notamment l'exposition à une violence multidimensionnelle. La prise en charge des violences de genre est d'une grande importance et le personnel de santé en constituent des acteurs clés. L'objectif de ce travail était d'étudier les connaissances et les pratiques du personnel de santé sur la santé sexuelle et reproductive (SSR) et les violences basées sur le genre dans les communes de Guédiawaye, Kaolack et Kolda au Sénégal. Une étude transversale descriptive et analytique a été menée. La population était constituée des professionnels de santé (médecins généralistes et spécialistes, infirmiers, sages-femmes) et des agents de santé communautaires (relais communautaires, bajénu gox, matrones). L'ensemble des structures de santé des trois communes ont été inclus avec un choix raisonné des cibles. Une analyse univariée une modélisation par une régression logistique a été effectuée pour rechercher les facteurs associés à la connaissance et la pratique du personnel de santé. Un risque alpha de 5% a été pris. Au total 78 professionnels de santé et 128 acteurs communautaires ont été inclus dans cette étude. Plus de la moitié du personnel de santé (56,3%) avaient une bonne connaissance des politiques, normes et protocoles (PNP) des services de santé sexuelle et reproductive des femmes (adolescentes) et environ 60% sur les conventions et Lois. Le niveau de connaissance était bon chez 51% des enquêtés et les pratiques bonnes chez 54,9%. Les facteurs associés à la bonne connaissance étaient la commune d'exercice de la profession, le fait de bénéficier d'une formation en construction sociale du genre. Les facteurs associés aux pratiques étaient la connaissance des PNP à travers la formation, les formations reçues en offre de services PF et contraception d'urgence, en prise en charge médico-psychosociale des cas de violences sexuelles. En conclusion, la connaissance des acteurs (professionnels de santé, agents de sante communautaires) sur la santé sexuelle et reproductive et les violences basées sur le genre est importante pour une meilleure offre de service et une bonne prise en charge des cas de violences. (Afr J Reprod Health 2024; 28 [8s]: 163-175).

Analysis of care for adolescent victims of gender-based violence in Senegal: a qualitative study.

In Senegal, many adolescent victims of gender-based violence (GBV) do not receive care. The aim of this study was to analyse the care circuit for adolescent victims of GBV, taking gender differences into account. This was a qualitative case study. A thematic analysis of the data was carried out using Nvivo 12 software. The study showed that society attached less importance to the rape of boys. The study also showed that the main attitude of adolescents to GBV was silence, encouraged by under-reporting. The structural barriers to providing care were the insensitivity of health and judicial structures towards adolescents, as well as geographical and financial obstacles. In conclusion, it is important for policies to tackle these structural barriers in order to promote a system of care suited to cases of GBV among adolescents.

Au Sénégal, de nombreux adolescents victimes de violences basées sur le genre ne sont pas pris en charge. L'objectif de cette étude est d'analyser le circuit de prise en charge des adolescent(es) victimes de VBG en tenant compte des différences de genre. Il s'agissait d'une étude qualitative de type étude de cas. Une analyse thématique des données avait été faite avec le logiciel Nvivo 12. L'étude a montré que la société accordait peu d'importance aux viols des garçons. L'étude a également montré que la principale attitude des adolescents face aux VBG était le silence, favorisant la sous-dénonciation. Les barrières structurelles à la prise en charge étaient l'insensibilité des structures sanitaires et judiciaires envers les adolescents, ainsi que les obstacles géographiques et financières. En conclusion, il est important que les politiques s'attaquent à ces barrières structurelles pour promouvoir un système de prise en charge adapté aux cas de VBG chez les adolescents.

Military affected by the first wave of COVID-19 in Senegal: stress and resilience factors during care.

COVID-19 had a psychological impact on the population, particularly those affected. Our objective was to investigate stress and resilience factors in the Senegalese soldiers affected during the first wave of COVID-19. Our retrospective and qualitative study included military personnel listed as contacts, suspects, or positive cases and supported by the Armed Forces Psychological Support Program during the period of isolation. The stress factors were health-related, sociological, and occupational. The conditions and the experience of isolation, stigmatization, and suspension of their professional projects were concerns for the soldiers. They had relied on personal, familial, and professional resources to cultivate resilience during the quarantine. Isolation during the pandemic showed psychological consequences, the foundations of which have been found in our study.

Synthetic hospital wastewater treatment by coupling submerged membrane bioreactor and electrochemical advanced oxidation process: Kinetic study and toxicity assessment.

In this work, the combination of membrane bioreactor (MBR) and electro-oxidation (EO) process was studied for the treatment of a synthetic hospital wastewater fortified with four pharmaceutical pollutants namely carbamazepine (CBZ), ibuprofen (IBU), estradiol (E-E) at a concentration of 10 µg L-1 venlafaxine (VEN) at 0.2 µg L-1. Two treatment configurations were studied: EO process as pre-treatment and post-treatment. Wastewater treatment with MBR alone shows high removal percentages of IBU and E-E (∼90%). Unlikely for CBZ and VEN, a low elimination percentage (∼10%) was observed. The hydraulic and the solid retention times (HRT and SRT) were 18 h and 140 d respectively, while the biomass concentration in the MBR was 16.5 g L-1. To enhance pharmaceuticals elimination, an EO pretreatment was conducted during 40 min at 2 A. This configuration allowed a 92% removal for VEN, which was far greater than both treatments alone, with lower than 30% and 50% for MBR and EO, respectively. The MBR-EO coupling (EO as post-treatment) allows high removal percentages (∼97%) of the four pharmaceutical pollutants after 40 min of treatment at a current intensity of 0.5 A with Nb/BDD as electrodes. This configuration appears to be very effective compared to the first configuration (EO-MBR) where EO process is used as a pre-treatment. Toxicity assessment showed that the treated effluent of this configuration is not toxic to Daphnia magna except at 100% v/v. The MBR-EO coupling appears to be a promising treatment for contaminated hospital effluents.