Availability and Utilization of Postabortion Care Services in Burkina Faso, Côte d'Ivoire, and Guinea: A Secondary Analysis of Emergency Obstetric and Neonatal Care Needs Assessments (EmONC).

SYNOPSIS: Generally, there are disparities in the availability and utilization of postabortion care services within the different regions at the national level in Burkina Faso, Cote d'Ivoire, and Guinea and between the 3 countries. Access to postabortion care at the primary level must be improved and the adoption of family planning when providing postabortion care. Unsafe abortion remains one of the leading causes of maternal mortality in sub-Sahara Africa, with relatively poor access to quality postabortion care (PAC) services. This study evaluated the quantity and distribution as well as the utilization of PAC services in Burkina Faso, Cote d'Ivoire, and Guinea. We conducted a secondary data analysis using the most recent EmONC surveys in the 3 countries between 2016 and 2017. We used PAC signal functions approach to assess facilities' capacity to provide basic PAC at both primary and referral level of care and comprehensive PAC at the referral level. We illustrated population coverage of PAC services based on the WHO benchmark, and then assessed the utilization of PAC services. Basic PAC capacity at primary level was low (36.6%), ranging from 16.2% in Burkina Faso to 36% in Cote d'Ivoire. About 82.0% of hospitals could provide comprehensive PAC. There were disparities in the geographical distribution of PAC services at both national and subnational levels. Abortion complications represented 16.2% of all obstetric emergencies, and uptake of PAC modern contraceptive was low (37.1%) in all countries. There is a need to focus on access to PAC at the primary level of care in the 3 countries.

[Dietary habits among type 2 diabetic patients attending the Abidjan Diabetes Centre]. / Pratiques alimentaires des diabétiques de type 2 suivis au Centre Antidiabétique d'Abidjan.

Objectives: The prevalence of diabetes is rapidly increasing in sub-Saharan Africa. Healthy lifestyle and dietary conditions play a key role in the control of blood sugar imbalance and cardiovascular complications of diabetes. This study was designed to describe the profile and dietary habits of type 2 diabetic patients attending the Abidjan Diabetes Centre (CADA), and to identify related factors. Methods: This cross-sectional, descriptive and analytic study was conducted in 2014 at the CADA. A total of 384 patients were included. Results: Patients had a mean age of 56.2 (SD: 11.7) years and had been living with diabetes for a mean duration of 8.6 years. Main comorbidities associated with diabetes were overweight (56.8%) and high blood pressure (45.3%). More than one-half of patients (60.7%) did not have a good knowledge of the recommended diet for diabetics: 88.5% did not have regular meal times, 11.7% reported snacking and 61.5% had their meals outside of the home. In addition, 60.4% stated that, during the week preceding the survey, they had eaten at least one "not recommended" food, most commonly fatty meals and fried food (31.5%). Patients who did not know that eating fatty meals and fried food was not recommended for diabetics were 3 times more likely to each this type of food (p < 0.001). Conclusion: Strengthening nutritional support by therapeutic education sessions is a key strategy that should be implemented to improve dietary habits among type 2 diabetic patients in Ivory Coast.

[Abortion practices in high school students in Yamoussoukro, Côte d'Ivoire]. / Pratiques d?avortement chez des lycéennes à Yamoussoukro, Côte d?Ivoire.

INTRODUCTION: Induced abortion is illegal in Cote d'Ivoire, except when the mother's life is in danger. The primary objective of this study was to describe abortion practices among Yamoussoukro high school students. More specifically, this study estimated the prevalence of induced abortion, described the pathway and the methods used for abortion and determined any abortion-related complications. MATERIAL AND METHODS: This cross-sectional study was conducted in July 2011 on 312 randomly selected girls attending the Lycée Jeunes Filles in Yamoussoukro. RESULTS: These girls had a mean age (SD) of 16.1 (4.7) years; 258 (82.7%) of them had already had sexual intercourse and 81 (31.4%) had already been pregnant. Fifty (61.7% [56.3-67.1%]) of these 81 girls had already had an abortion. The abortion pathway was as follows: the main method was self-prescribed medication (70%) as first attempt, followed, in case of failure, by traditional healers (56.4%). Healthcare practitioners were usually consulted at the third attempt (85.7%). The most commonly used methods of abortion were drugs (91.9%), ingestion of plants/beverages (68.5%) and introduction of devices into the uterine cavity (62.3%). Twenty-two (44%) out of 50 induced abortions resulted in complications, mostly infectious complications (81.8%), and bleeding (68.2%). Complications were significantly associated with self-induced abortions or abortions performed by traditional healers (p < 0.001). CONCLUSION: More intensive sexual education, access to modern methods of contraception, awareness campaigns concerning the risks related to unwanted pregnancies and abortions performed by non-medical personnel need to be implemented to prevent school abortions. The quality and accessibility of post-abortion services also need to be reinforced.