Détection et contrôle de l'hypertension artérielle dans une communauté péri-urbaine d'Afrique de l'Ouest.

INTRODUCTION: The detection of hypertension in African countries ranges from 15 to 40%, so more than half of hypertensive people are unaware of their condition. In Côte d’Ivoire, very little work on the detection of hypertension exists. PURPOSE OF RESEARCH: The objective was to analyze the detection and control of hypertension in the Ivorian peri-urban environment. RESULTS: Three hundred and sixty (360) participants were interviewed. Among them, 47.8% (172 participants) had their BP measured in the past 12 months. Sixty-seven individuals were classified as hypertensive of whom 30 had already been detected (44.8%). The control of hypertension was 60%. Higher probabilities of detection were associated with participation in physical activity (OR = 3.27 95% CI: 1.08-10.54). CONCLUSIONS: The detection of hypertension, although relatively high in Anonkoi 3, still concerned less than half of the hypertensives. Hence the interest in raising public awareness of systematic screening for hypertension.

Renoncement aux soins pour raisons financières des femmes d'un quartier périurbain d'Abidjan en Côte d'Ivoire.

INTRODUCTION: Cessation of care for financial reasons is an indicator of the affordability of care. OBJECTIVE: The objective of this work was to identify the determinants of the renunciation of care for financial reasons among women in a peri-urban area of Abidjan. METHOD: This cross-sectional study was conducted from March to May 2019 among women aged 18 years and over in Anonkoi 3 in the north of Abidjan. The socio-demographic, economic, health status and health care abandonment characteristics were collected using a questionnaire. The associations between the renunciation of care for financial reasons and women’s characteristics were measured using logistic regression models with a 5% risk. RESULTS: The sample consisted of 423 women with a median age of 28 ± 11 years. Only 30% of them had health insurance. The rate of financial reasons for discontinuing care was 59.1%. This renunciation was more pronounced for the purchase of drugs, biological examinations, dental care, and surgical procedures. The number of dependent (P = 0.035), young age (P ≤ 0.035), low level of education (P = 0.024), low level of income (P ≤ 0.004) and the absence of an associative life (P = 0.004) and perceived poor health (P = 0.021) were identified as determinants of the renunciation of care for financial reasons. CONCLUSION: Empowerment, literacy, health education for women and adherence to universal health coverage should help to remove the financial barrier to women’s access to care.

Distribution of out of pocket health expenditures in a sub-Saharan Africa country: evidence from the national survey of household standard of living, Côte d'Ivoire.

OBJECTIVE: The purpose and objective of our research is to identify the determinants of the out of pocket (OOP) health expenditures in the population of Ivory Coast and the ratios across three different area; Abidjan, the rural and urban area. We used data from the 2015 standard households living survey conducted by the National Institute of Statistic. RESULTS: About 6315 (13.3%) of the participants had experienced OOP health expenditure. There was significant differences in the self-reported OOP between these three areas (p < 0.001). The overall mean of OOP expenditure among all participants was 16,034.33 XOF (29 USD). People in Abidjan spent an average of 1.6 and 1.5 times more than those in the rural and urban areas respectively (p < 0.001). Hospitalization is the highest expenditure item in terms of money spent, while drugs are the most common item of expenditure in terms of frequency, regardless of the place of residence. Female gender, high social economic status and large household size increase OOP health expenditure significantly in all areas of residence when insurance reduce it. To reduce the impact of the direct payments there is a need to take into account social demographic factors in addition to economic factor in health policy development.