Do users of skin-lightening products recognize their consequences? A socio-anthropological study on awareness of skin depigmentation consequences among female users in Burkina Faso.

Skin depigmentation's sociocultural and health impacts are widely studied. This socio-anthropological study in Bobo-Dioulasso, Burkina Faso, involving 46 women, explores their awareness of both positive and negative effects of skin-lightening products. Ethical standards guided the research, which included a literature review and in-depth interviews. Users recognize benefits like improved self-esteem and social status, alongside health risks like skin diseases and sun sensitivity. The decision to use these products reflects a thoughtful balance of personal, social, and economic benefits against potential health risks, indicating a nuanced understanding of skin depigmentation's impacts.

Facteurs structurels et communautaires augmentant la vulnérabilité des hommes ayant des relations sexuelles avec des hommes dans la riposte au virus de l'immunodéficience humaine au Burkina Faso.

INTRODUCTION: Worldwide and particularly in Africa, Men who have sex with men (MSM) can play a significant role in response to the Human Immunodeficiency Virus (HIV). In Burkina Faso the fight against HIV within this population seems to be limited by violence towards MSM. PURPOSE OF RESEARCH: The goal of this study was to identify the social obstacles to HIV response among MSM in Burkina Faso. METHODS: It has been a descriptive study with an exploratory aim in a mainly qualitative approach. It was conducted in the two biggest cities as well as two border ones of the country. Nonstructural interviews have been conducted with the help of prevention MSM actors. The data have been thematically analyzed. RESULTS: In the structural level, homosexuality is publically condemned by politicians some of whom seeking its criminalization. According to them it has "come from elsewhere" and is "contrary to morals". Even though there is no legally punishing regulation against it, political and administrative authorities and security forces do not protect MSM against homophobic violence. There is not enough care structures for MSM in the country. At the community level, many religious leaders condemn homosexuality, considered as a sin; they view homosexuality as an "abomination". MSM feel that they are victims of homophobic violence. CONCLUSIONS: The MSM are victims of violence from populations and state institutions too. To reach MSM by activities in response to HIV these obstacles must necessarily be removed.

Acceptance and challenges of the introduction of the routine community-based vitamin A supplementation strategy: the case of Burkina Faso.

OBJECTIVES: With the phase-out of the polio campaigns, Burkina Faso has developed a new strategy for routine community-based vitamin A supplementation (VAS) by institutionalising community-based health workers (CBHW) to sustain the gain of two decades of successful programming. Formative research was conducted soon after the strategy was introduced to solicit feedback on the acceptability of the new approach by the implementing actors while identifying the main implementation challenges for improving its effectiveness and sustainability. DESIGN: This qualitative study was conducted in 2018 through (i) document review, (ii) individual interviews with key informants at the central, regional and district levels, and (iii) focus groups with CBHW and caregivers. SETTING: Data collection was carried out at six levels of sites covering the entire country and selected based on VAS coverage rates with the community routine. A total of six health districts were selected. PARTICIPANTS: We conducted 46 individual interviews with health workers and 20 focus groups with 59 CBHW and 108 caregivers. RESULTS: The study showed good acceptability of the strategy by all stakeholders. In the first 2 years of implementation, the national coverage of VAS was maintained at a high level (above 90 %) and there was a reduction in operational costs. The main challenges included delayed CBHW remuneration and weak communication and supervision. CONCLUSIONS: The acceptability of the community-based routine VAS was good and was perceived to have a high potential for sustainability. Addressing identified challenges will allow us to better manage the expectations of community stakeholders and maintain the initial results.

Qualitative evaluation of a knowledge transfer training programme in maternal and child health in Burkina Faso, West Africa.

The study evaluated a first session of the knowledge transfer training programme organised for Ministry of Health workers in the area of maternal and child health in Burkina Faso. The objective was to obtain the participant's perceptive for improving the training programme. A qualitative study was conducted during and after the first training session, using the four levels of Kirkpatrick training evaluation framework. A group discussion was organised with 17 participants during the training and a few weeks after the first training session, 11 of them were interviewed again. A thematic analysis of the transcribed interviews was done in line with the objectives of the evaluation. We noted that the participants had a good impression of the training, in relation to their expectations, the adequacy and quality of the teaching. The 11 post-training interviewees stated that they had acquired knowledge and skills relevant to their work. Using the learner's behavioural change model, three groups emerged as a result of the training. The first group expressed intent to use the knowledge gained, the second group set conditions for the effective application of the knowledge acquired, including the enabling professional environment. While the third group felt that despite the knowledge and skills they had acquired, they would need assistance with the applying the skills at their jobs. In conclusion, the training improved the capacity and skills of health workers, but an enabling professional environment and support will facilitate the application of knowledge.

Mesures visant à renforcer l'observance pour les antirétroviraux : perceptions et expérience des PVVIH au Burkina Faso.

INTRODUCTION: Adherence to antiretroviral therapy is a major obstacle to achieving WHO target 3. In West Africa, however, there is a lack of evidence on the most feasible, acceptable and effective adherence reinforcement measures and users' perceptions of these measures. The purpose of this article is to analyze the perceptions of PLHIV (people living with HIV) on ART reinforcement measures in Burkina Faso. METHOD: In Ouagadougou and Bobo-Dioulasso care centers, THILAO Research Project (ANRS 12269) enrolled PLHIV experiencing therapeutic failure on 2nd line antiretroviral treatment, and offered to them adherence reinforcement measures. We conducted a qualitative socio-anthropological study to explore their perceptions. Data were collected through repeated individual interviews with 37 PLHIV. RESULTS: The 31 participants who completed interviews were relatively satisfied with the measures to support adherence. Three measures (pill organizer, weekly phone calls by a member of the team, cellphone alarm reminders) were perceived as simple, effective, discreet, adapted to both illiterate and educated people. Three other measures (home visits, involvement of a member of the family and SMS) were not highly appreciated as they expose to the disclosure of HIV+ status and /or stigmatization. Two measures (support group, frequent visits to the care center) were less selected because considered tedious. CONCLUSION: PLHIV chosed and used the most appropriate adherence measures for their profile / context. The most feasible and acceptable measures identified could be offered to PLHIV at risk of non-compliance in West African ART programs.

[Adherence reinforcement for antiretroviral therapy: PLHIV's perceptions and experience in Burkina Faso]. / Mesures visant à renforcer l'observance pour les antirétroviraux : perceptions et expérience des PVVIH au Burkina Faso.

INTRODUCTION: Adherence to antiretroviral therapy is a major obstacle to achieving WHO target 3. In West Africa, however, there is a lack of evidence on the most feasible, acceptable and effective adherence reinforcement measures and users' perceptions of these measures. The purpose of this article is to analyze the perceptions of PLHIV (people living with HIV) on ART reinforcement measures in Burkina Faso. METHOD: In Ouagadougou and Bobo-Dioulasso care centers, THILAO Research Project (ANRS 12269) enrolled PLHIV experiencing therapeutic failure on 2nd line antiretroviral treatment, and offered to them adherence reinforcement measures. We conducted a qualitative socio-anthropological study to explore their perceptions. Data were collected through repeated individual interviews with 37 PLHIV. RESULTS: The 31 participants who completed interviews were relatively satisfied with the measures to support adherence. Three measures (pill organizer, weekly phone calls by a member of the team, cellphone alarm reminders) were perceived as simple, effective, discreet, adapted to both illiterate and educated people. Three other measures (home visits, involvement of a member of the family and SMS) were not highly appreciated as they expose to the disclosure of HIV+ status and /or stigmatization. Two measures (support group, frequent visits to the care center) were less selected because considered tedious. CONCLUSION: PLHIV chosed and used the most appropriate adherence measures for their profile / context. The most feasible and acceptable measures identified could be offered to PLHIV at risk of non-compliance in West African ART programs.

The West African experience in establishing steering committees for better collaboration between researchers and decision-makers to increase the use of health research findings.

BACKGROUND: Aware of the advantages of a project steering committee (SC) in terms of influencing the development of evidence-based health policies, the West African Health Organisation (WAHO) encouraged and supported the creation of such SCs around four research projects in four countries (Burkina Faso, Nigeria, Senegal and Sierra Leone). This study was conducted to describe the process that was used to establish these committees and its findings aim to assist other stakeholders in initiating this type of process. METHODS: This is a cross-sectional, qualitative study of the initiative's four projects. In addition to a literature review and a review of the project documents, an interview guide was used to collect data from 14 members of the SCs, research teams, WAHO and the International Development Research Center. The respondents were selected with a view to reaching data saturation. The technique of thematic analysis by simple categorisation was used. RESULTS: To set up the SCs, a research team in each country worked with health authorities to identify potential members, organise meetings with these members and sought the authorities' approval to formalise the SCs. The SCs' mission was to provide technical assistance to the researchers during the implementation phase and to facilitate the transfer and use of the findings. The 'doing by learning' approach used by each research team, combined with WAHO's catalytic role with each country's Ministry of Health, helped each SC manage its contextual difficulties and function effectively. CONCLUSION: The involvement of technical and financial partners motivated the researchers and ministries of health, who, in turn, motivated other actors to volunteer on the SCs. The 'doing by learning' approach made it possible to develop strategies adapted to each context to create, facilitate and operate each SC and manage its difficulties. To reproduce such an experience, a strong understanding of the local context and the involvement of strong partners are required.

Plaidoyer pour un renforcement du système de pharmacovigilance au Burkina Faso.

Large-scale deployment of new medicines has been observed over the last two decades in many Sub-Saharan Africa countries faced with major public health issues such as malaria and HIV/AIDS. However, some of these medicines may be responsible for varying degrees of toxicity, with adverse drug reactions leading to decreased compliance or even discontinuation of treatment. Pharmacovigilance systems therefore had to be set up in these countries, such as in Burkina Faso, West Africa, which initiated the organization of pharmacovigilance activities in 2008. Despite this progress, the systems in place have not yet achieved a sufficient level of performance to deal with drug-related health issues, highlighting the need for further actions. Pharmacovigilance in Burkina Faso can be strengthened at multiple levels: pre-service and in-service training of health workers; the establishment of active surveillance based on sentinel sites; informing the public and raising awareness; and strengthening national coordination.

[Knowledge, attitudes and condom use skills among youth in Burkina Faso]. / Utilisation du préservatif masculin : connaissances, attitudes et compétences de jeunes burkinabè.

Introduction: Condom use is recognized by the WHO as the only contraceptive that protects against both HIV / AIDS and unwanted pregnancies. But to be effective, condoms must be used consistently and correctly. The objective of this study was to assess young people's skills in male condom used, to identify the challenges faced by them when using condoms to better guide future interventions.Methods: Based on a two-level sampling representing 94,947 households within Bobo-Dioulasso municipality, 573 youth aged between 15 and 24 were interviewed. This data collection was conducted from December 2014 to January 2015 in the three districts of the municipality. A questionnaire was used to assess the knowledge and attitudes of the youth.Results: Only 24% of surveyed know how to accurately use condoms despite their knowledge of condom effectiveness and although some of them are exposed to awareness-raising and information campaigns. Indeed, various handling errors and usage problems (breakage, slippage, leakage and loss of erection) had been identified during the oral demonstration performed by the surveyed. The older youth and with the highest level of education were the most likely to demonstrate increased skills in condom use. Moreover, girls were less competent than boys in terms of condom use.Conclusion: It is important to increase awareness-raising and information campaigns, adapting the content to the real needs of young people so as to transmit the skills required for effective prevention particularly in regard to condom use.

[Potentially inappropriate medication use in elderly care in Burkina Faso]. / Utilisation des médicaments potentiellement inappropriés dans les soins gériatriques au Burkina Faso.

These results suggest approaches to encourage the development of care provider skills, standardized practices and rational prescription to help improve medication use in the elderly..

Knowledge and attitude of young people regarding HIV prevention and unwanted pregnancy in Bobo-Dioulasso, Burkina Faso / Connaissances et attitudes des jeunes de Bobo-Dioulasso en matière de prévention du VIH et de la grossesse non désirée.

Introduction: Despite health education efforts, young people are still faced with major health problems. The objective of this study was to assess the knowledge and attitude regarding HIV prevention and unwanted pregnancy among young people in Bobo-Dioulasso, Burkina Faso. Methods: Based on two-level sampling, representing 94,947 households in the Bobo-Dioulasso municipality, 573 young people between the ages of 15 and 24 years were interviewed. This data collection was conducted from September 2014 to January 2015 in the three districts of the municipality. A questionnaire was used to assess the knowledge and attitudes of young people. Results: The interviewees had a poor knowledge about HIV transmission and prevention and contraception Very few young people (9%) had complete knowledge about the modes of transmission and 5% had no knowledge. Persistent misperceptions about the effectiveness of condoms (25%) and contraception (32%) did not prevent some young people from using them (79% used condoms and 46% used contraceptives). Knowledge and attitudes of young people regarding HIV and contraception varied according to age, sex, education level and type of parental supervision. Conclusion: A significant proportion of young people still has incomplete knowledge about HIV/AIDS and contraception. Actions designed to reinforce the knowledge of young people are of paramount importance. The capacities of parents and healthcare providers also need to be reinforced to improve the quality of relationship with young people.

Obstetric Fistula "Disease" and Ensuing Care: Patients' Views in West-Africa.

We explored obstetric fistula patients' real-life experience of care in modern Health System. Our aim was to analyze how these women's views impacted their care uptake and coping. We conducted 67 in-depth interviews with 35 fistula patients or former patients in 5 fistula repair centers within referral hospitals in Mali and Niger. Perceptions of obstetric fistula influenced the care experience and vice versa. Obstetric fistula was viewed as a severe chronic disease due to length of care process, limitation of surgery and persisting physical and moral suffering. We highlight the opportunity to build on patients' views on obstetric fistula trauma and care in order to implement an effective holistic care process.

Prevalence and patterns of multimorbidity among the elderly in Burkina Faso: cross-sectional study.

OBJECTIVES: To assess the prevalence and distribution patterns of multimorbidity among urban older adults in Burkina Faso. METHODS: Cross-sectional study among community-dwelling elderly people aged ≥60 in Bobo-Dioulasso. We performed interviews, clinical examination and medical record review. Multimorbidity was defined as co-occurrence of at least two chronic diseases in one person whether as a coincidence or not. RESULTS: The overall prevalence of multimorbidity among older adults was 65%. Age ≥70 was associated with multimorbidity in multivariate analysis: adjusted OR = 1.65, 95% CI (1.01-2.68, P = 0.04). The most common chronic diseases were hypertension (82%) 95% CI (78; 86), malnutrition (39%) 95% CI (34; 44), visual impairments (28%) 95% CI (24; 33) and diabetes mellitus (27%) 95% CI (22; 31). Those aged ≥70 had significantly more malnutrition (50% vs. 31%, P = 0.0003) and osteoarthritis (8% vs. 3%, P = 0.01) than those aged 60-69. CONCLUSIONS: The high prevalence of multimorbidity requires a reorganization of healthcare systems in sub-Saharan Africa, especially in Burkina Faso. Interventions and care guidelines usually focused on individual diseases should be improved to better reflect this reality.

The key actors maintaining elders in functional autonomy in Bobo-Dioulasso (Burkina Faso).

BACKGROUND: Globally, a significant increase in functional disability among the elderly is expected in the near future. It is therefore vital to begin considering how Sub-Saharan Africa countries can best start building or strengthening the care and support system for that target population. Study objectives are: 1) identify the key actors of the social system who maintain elders in functional autonomy at home in Bobo-Dioulasso (Burkina Faso) and 2) to describe the functional status of older people living at home. METHODS: We conducted a longitudinal descriptive study among the elderly aged 60 and above (351). Their functional status was evaluated using the Functional Autonomy Measurement System (SMAF). Data analysis was done using the statistical software package STATA (SE11). RESULTS: In Bobo-Dioulasso, 68% of seniors have good functional capacity or a slight incapacity and 32% have moderate to severe incapacities. Older people die before (3%) or during (14%) moderate to severe disabilities. This would mean that the quality of medical and/or social care is not good for maintaining functional autonomy of older people with moderate to severe disabilities. Two main groups of people contribute to maintain elders in functional autonomy: the elderly themselves and their family. Community, private or public structures for maintaining elders in functional autonomy are non-existent. The social system for maintaining elders in functional autonomy is incomplete and failing. In case of functional handicap at home, the elders die. But stakeholders are not conscious of this situation; they believe that this system is good for maintaining elders in functional autonomy. CONCLUSION: It is likely that the absence of formal care and support structure likely shortens the lifespan of severely disabled older people. Stakeholders have not yet looked at this possibility. The stakeholders should seriously think about: 1) how to establish the third level of actors who can fulfill the needs to maintain elders in functional autonomy that are not satisfied by others (family members or the older individuals themselves), and 2) how to reinforce the role of each actor and the collaboration between the different groups of people of this system.

[Governance of HIV/AIDS organizations in Bobo-Dioulasso (Burkina Faso)]. / La gouvernance au sein des organisations de lutte contre le VIH à Bobo-Dioulasso (Burkina Faso).

INTRODUCTION: Although HIV/AIDS organizations continue to play a major role in the fight against pandemic HIV infections, they are still faced with enormous governance challenges that impair their operations / interventions and their sustainability. The objective of this study was to develop an inventory of the quality of governance within HIV/AIDS organizations in Bobo-Dioulasso. METHODS: This qualitative research was conducted in 40 organizations from Bobo-Dioulasso. Qualitative data were collected over a 45-day period using an interview guide. Thematic analysis of the data was performed and the results were reported. RESULTS: Although all 40 organizations had established good governance mechanisms, only fifteen complied with the major rules of democratic functioning and the roles of the various bodies. The majority of these organizations (29/40) ignored many democratic rules. The number of members required for the Executive Board was not met in 29/40 organizations resulting in monopolization of decision-making by a handful of people. Technical and financial reports were not published, resulting in limited access to information on the organization's activities. Gender equality also constituted a weakness. DISCUSSION: Application of good governance principles was limited in these organizations. Organization members, leaders and technical and financial partners must reinforce good governance efforts in order to improve good governance in these organizations.

[Quality of chronic patient care according to the Chronic Care Model in Burkina Faso]. / Qualité de la prise en charge des malades chroniques au Burkina Faso selon le Chronic Care Model.

INTRODUCTION: There is a lack of organizational knowledge concerning optimal management by the health care system for patients with chronic health conditions in sub-Saharan Africa. The objective of this study was to describe the quality of chronic patient care at first-line heath facilities in Bobo-Dioulasso, Burkina Faso. METHODS: We conducted a cross-sectional study in six health facilities in Bobo-Dioulasso from October to November 2013. The chronic care model was used as a reference to describe the care of hypertensive patients. A score was calculated for each item in the model, and the strengths and weaknesses of health care organization were identified RESULTS: The overall level of support for the management of hypertensive patients was "basic" for all surveyed structures: median score and IQR 3.7 (3.4, 4.4). The level of support was basic for primary health facilities (median score 4.4), district hospitals (median score 4.1) and the University health center (median score 5.4). The relationship with the community and support to decision-making were identified as weak components of the model. CONCLUSIONS: To improve the quality of chronic patient care in first-line health facilities in Burkina Faso, efforts must be made to strengthen clinical governance and partnership with the community.

[Analysis of the Burkinabe National Health Program for the Elderly (BNPEH) 2008-2012]. / Analyse du Programme National de Santé des Personnes Agées (PNSPA) 2008-2012 du Burkina Faso.

INTRODUCTION: As a result of ageing of the population, most countries of sub-Saharan Africa, either spontaneously and/or in response to international incentives, are starting to develop sectorial or multisectorial action plans in favour of the elderly. Are these plans relevant and consistent and do they improve the health of the elderly? This study was performed to assess the relevance, consistency and implementation of the National Health Programme for the Elderly (PNSPA) 2008-2012 in Burkina Faso. METHODS: This qualitative analysis was conducted in Ouagadougou in November-December 2011 in 47 subjects including 27 elderly subjects and 20 stakeholders responsible for the design and/or implementation of the PNSPA. These respondents were selected rattionally and were individually interviewed. Content analysis was therefore performed. RESULTS: The PNSPA is relevant in the Burkinabe context. It takes into account the health needs of elderly people in Burkina Faso as well as the availability of resources in health centres. It presents several consistency problems. It has rarely been implemented due to lack of political support and inadequate financial resources. DISCUSSION: The Burkina Faso PNSPA has encountered more difficulties than similar plans in Senegal and Mali, which have also encountered low implementation rates. This situation confirms that the elderly in sub-Saharan Africa constitute a top priority vulnerable population but which is neglected by all actors to varying degrees.

[The elderly in sub-Saharan Africa: a vulnerable population often ignored in public policy]. / Les personnes âgées en Afrique subsaharienne : une population vulnérable, trop souvent négligée dans les politiques publiques.

Many people and financial institutions believe that the elderly are not a priority in sub-Saharan Africa, a region marked by serious economic, socio-political and health crises. The purpose of this paper is to describe and analyze the assumptions and arguments underlying this view and to demonstrate that the elderly are a vulnerable priority population ignored by all stakeholders and primarily by technical and financial partners. The premise is that development must be viewed as a whole. In addition to improving the living conditions of children, youth and women, efforts to promote development in Africa must also take into account the needs of the elderly. The paper argues that there are four main reasons for focusing on the elderly in sub-Saharan Africa: systemic reasons, ethical/humanitarian reasons, developmental reasons and/or the interests and future of youth and adults.

[Medium-term acceptability of HIV vaccine clinical trials in Burkina Faso: stakeholders' perceptions]. / Acceptabilité d'un essai vaccinal contre le VIH à moyen terme au Burkina Faso: perceptions des acteurs.

INTRODUCTION: The ideal response to HIV would be the discovery of an effective vaccine. Evaluation of the benefit/risk balance of this vaccine must include Africa, where the majority of HIV infections are observed. This study was designed to identify the perceptions and the medium-term acceptability of a potential vaccine trial in Ouagadougou (Burkina Faso). METHODS: After a "literature review", data were collected from key informants, "pimps" of prostitutes, representatives of HIV and/or AIDS associations, facilitators and peer educators. Data were transcribed and analysed manually. RESULTS: The vast majority of respondents considered that it would be relevant to test an HIV vaccine in Ouagadougou (Burkina Faso). Almost all prostitutes would participate in such a trial and would be motivated by several factors. Potential participants were willing to play the role expected of them. A real communication strategy will be needed to conduct this trial. DISCUSSION: The results of this study are similar to those of previous studies conducted in Burkina Faso concerning the acceptability/feasibility of clinical trials. Acceptability studies of clinical trials are therefore becoming less and less relevant. Reinforcing the skills/capacities of all stakeholders and/or adequate preparation of participants to play the role expected of them are therefore now more important than acceptability studies.

[The Burkinabe experience of the creation of a Community Advisory Committee to improve the support of HIV research projects]. / L'expérience burkinabè de constitution d'un Comité Consultatif Communautaire pour un meilleur accompagnement des projets de recherche sur le VIH.

INTRODUCTION: Community Advisory Committees (CAC) have become indicators of good community involvement in health research all over the world. CACs have been developed only recently in several Sub-Saharan African countries. Many countries wonder about how to create and ensure good functioning of a community advisory committee. The objective of this article is to describe the creation of two CACs in Burkina Faso. METHODS: This qualitative study comprised a literature review phase, a data collection phase conducted on a sample of 27 subjects (research scientists, representatives of AIDS associations or networks and the local technical and/or financial partners of these associations) and an implementation phase. Study participants were selected on a rational basis, the study complied with the ethical principles of research and data were transcribed and analysed manually. RESULTS: Scientists and/or community workers may initiate the creation of a CAC based on the following main elements: the profile of individuals and/or structures, the dynamism of CAC members, reinforcement of their skills and capacities. The CAC must be independent of research scientists and must be designed to be sustainable. DISCUSSION: The difficulties of sustainability and the poor perception of CACs remain major challenges. Continuing collaboration between CAC members and research scientists improves their knowledge in the field of research ethics, allowing the community to perceive CACs as supporters of research.