Perception des acteurs de l'approche « Une Seule Santé ¼ de la sécurité sanitaire mondiale au Bénin.

INTRODUCTION: The perception of human resources is essential for their commitment in strengthening health security. The study assessed the perception of the “one health” approach stakeholders on global health security in Benin. METHODS: The study was qualitative, cross-sectional and quantitative. Non-probability sampling method with purposive choice were used to select 55 actors from health, veterinary and environmental sectors, and from community. Individual interviews and three focus groups were used to collect data; The content analysis was used to perform thematic groupings. RESULTS: Respondents had a good knowledge of threats (73%), events (59%) and information mechanisms (68%). The health security environment was characterized by the absence of an integrated mechanism for information sharing, episodic and unbalanced collaboration, a difference between the level of organization of the sectors with health sector perceived as better organized by 92% of respondents. The environment is presented as the sector requiring major reinforcements. Community involvement was also episodic. The sectors were dependent on the partners. The community was not involved in setting priorities and lacked commitment to health security. The regulatory component is insufficient, and no law enshrines the international health regulations as a reference. For 60% of respondents, health security was a reality in Benin and 21% were satisfied with it. Respondents had a good perception of health security and its challenges in Benin. CONCLUSION: The strengthening of legislation and collaboration is necessary for the improvement of global health security in Benin.

Évaluation des capacités du système de laboratoires biologiques pour la détection des menaces infectieuses au Bénin.

Background : International Health Regulations require countries to establish laboratory systems for rapid and safe confirmation of public health emergencies.Objective : This study assessed the capacity of the National Laboratory System for the detection of infectious threats to global health security in Benin.Method : The study was descriptive, cross-sectional, and evaluative. The targets were laboratories performing the confirmation of infectious threats. The sampling method was non-probabilistic with the reasoned choice of 74 laboratories. Four collection tools were used. The World Health Organization’s laboratory assessment tool for health facilities was used to assess the national public health laboratory. The assessment was based on the capacities of peripheric laboratories and of the national reference laboratory. The capacity was rated good if at least 80% of peripheric laboratories met at least 80% of the criteria and if the national public health laboratory had an average indicator of at least 80%. Otherwise, the capacity was rated insufficient.Results : The national laboratory system capacity was insufficient. Only 54% of peripheric laboratories had good capacity. The national reference laboratory had an average indicator of 71%. In this reference laboratory, specimen collection and transport, laboratory testing performance, consumables and reagents, and public health functions had the best scores, above 80%. Biorisk management, organization and management, and documents had the lowest scores. In peripheric laboratories, the testing performance was the only domain with good capacity.Conclusion : To ensure effective Global Health Security in Benin, a National Laboratory System capacity improvement strategic plan need to be developed and implemented.

Évaluation des capacités de détection des menaces infectieuses aux points d'entrée au Bénin.

BACKGROUND: The International Health Regulation requires countries to establish measures at border entry points to prevent the spread of infectious threats across borders. OBJECTIVE: This study assessed the capacity for the detection of infectious threats to global health security at entry points in Benin in 2021. METHODS: This cross-sectional and descriptive study was conducted at 17 borders. Collection techniques included individual interview, observation, and document exploitation. Each entry point capacity was rated good if the entry point met at least 80 % of input criteria and 80 % of process criteria and 80 % of output criteria. The overall detection capacity was rated good if at least 80% of entry points had good capacity. Otherwise, the capacity was deemed insufficient. RESULTS: The capacity for the detection of infectious threats at entry points in Benin was insufficient. There was no entry point (0.0%) that reach 80% of inputs criteria. 11.8% of them reached 80% of process criteria and 5.9% reached 80% of output criteria. There was no entry point with good detection capacity. The travelers’ screening was not systematic. Only 19.4% of human travelers, 12.8% of food loads and 0.1% of animals were screened the day before the survey. Two alerts among human travelers, four among animals and one food safety alerts were detected. Health teams were present in all designated entry points, but they were only focused on Covid-19. CONCLUSION: Strengthening the detection system and extending it to other threats is necessary to improve the detection capacity at entry points.

[Factors associated with the quality of sterilization of surgical drapes at the National Hospital University Hubert Koutoukou Maga of Cotonou]. / Facteurs associés à la qualité de la stérilisation du linge opératoire au Centre National Hospitalier Universitaire Hubert Koutoukou MAGA de Cotonou.

INTRODUCTION: The sterilization of surgical drapes plays an important role in preventing infections associated with treatments. At the CNHU-HKM, sterilization procedure for drapes encounters problems. The purpose of this study was to examine the factors associated with the quality of sterilization of surgical drapes at the CNHU-HKM. METHODS: We conducted a cross-sectional, descriptive and analytical study focusing on 20 sterile surgical drapes, 41 agents were involved in the management of drapes and 55 members of the surgical team. The probabilistic method was used for sterile surgical drapes, the non-probabilistic method for the others. Pearson's Chi-square Test and logistic regression were used to find the association, with a significant threshold and a p<0.05. RESULTS: Eighty six point forty six percent of subjects were males with an average age of 42 years. The quality of the process of sterilization of the operative drapes was not good in the two departments responsible for processing the drapes. Bacteriological analysis showed that, out of 20 sterile surgical drapes, 9 had Acinetobacter spp. a multidrug-resistant germ causing nosocomial infections. Multivariate analysis showed that professional experience (p=0.015) and quality control of the procedure (p=0.034) were statistically associated with the quality of sterilization. CONCLUSION: The presence of Acinetobacter spp. on the sterilized drapes demonstrates that sterilization of drapes at the CNHU-HKM is of poor quality. Measures strengthening the skills of providers are necessary to improve the quality of sterilization procedures.

[Capacity of response of the health system to the expectations of populations in zones exposed to results-based financing in Benin in 2015]. / Capacité de réponse du système de santé aux attentes des populations dans les zones exposées au financement basé sur les résultats au Bénin en 2015.

Introduction: The increased use of results-based financing (RBF) services was the basis for this study designed to evaluate the contribution of RBF to the capacity of response of the health system to the population's expectations. Methods: This study, conducted in six Benin health zones randomly selected in two strata exposed to RBF (FBR_PRPSS and FBR_PASS) and one zone not exposed to RBF (Non_FBR), examined the seven dimensions of reactivity. A score, followed by weighting of their attributes, was used to calculate the index of reactivity (IR). Results: Sixty-seven health care units and 653 people were observed and interviewed. The FBR_PRPSS and FBR_PASS strata, managed by the new provisions of RBF, displayed good performances for the "rapidity of management" (70% and 80%) and "quality of the health care environment" dimensions, with a more marked improvement for the PRPSS model, which provides greater resources. Poor access to social welfare networks in the three strata led to renouncing of health care. The capacity of response to expectations was moderate and similar in the Non_FBR (IR = 0.53), FBR_PASS (IR = 0.62) and FBR_PRPSS (IR = 0.61) strata (p > 0.05). Conclusion: The FBR_PRPSS and FBR_PASS models have a non-significant effect on the capacity of response. Their success probably depends on the health system context, the combination of targeted interventions, such as universal health insurance, but also the importance and the use of the new resources that they provide.