Factors Associated With Condom Use Among High School Students of Natitingou Agricultural Technical School, Benin, in 2017.

INTRODUCTION: HIV/AIDS is one of the most dreaded diseases of this century. Condom use is probably the most effective way to combat the disease. Objective: To study the factors associated with condom use among high school students in Natitingou in 2017. METHODS: A descriptive cross-sectional analytical study involving 202 individuals, based on non-random sampling technique with exhaustive choice. Collected data were processed and analyzed with Epi-Data 3.1 and Epi-Info 7. RESULTS: 128 male and 74 female students were included in the study. Mean age was 19.51 years. Prevalence of condom use was 40.63%. Factors associated with condom use were: level of education, injecting drug use, knowing one's HIV status, ease access to condom, friends' point of view on voluntary testing. CONCLUSIONS: There is still room for improving the prevalence of condom use among high school students, and this suggests the social gradient perspective that other more in-depth studies will be able to specify.

[Health promotion in Africa: history and prospects]. / La promotion de la santé en Afrique : histoire et perspectives d'avenir.

Since the Ottawa Charter (1986), the majority of regions of the world has done considerable progress in health promotion (HP) and has got frameworks of reflection, methodologies and tools related to it. In Africa, HP was adopted by the Member States of the WHO regional office of Africa since 2001. However many efforts remain to be deployed at countries' level for its appropriation in the context of the triple burden of communicable diseases, non-communicable diseases and socio-behavioral over the region. Francophone Africa barely begins to take its first steps in the recognition and adoption of this approach. It favors however strategies such as information, education and communication (IEC), health education (HE), behavior change communication (BCC), social mobilization, social marketing, etc. Things are stressed and done under HP theme without for as much fit in its characteristics. What is the current situation in francophone Africa ? The particularities of HP evolution in this region and its practice by professionals with regard to the priority health issues of the region deserve reflection. This is the question to which it is proposed to answer in this article. We will review, among other things, HP history and why it matters, then briefly the various concepts and strategies used. We will finish by the potential development of HP in the region.

Prévalence et facteurs associés à la co-consommation d'alcool et de tabac dans la commune de Natitingou, Bénin.

INTRODUCTION: La consommation d'alcool et la consommation de tabac entraînent chacune des risques importants pour la santé. L'objectif de cette étude était d'étudier la prévalence de la co-consommation d'alcool et de tabac ainsi que les facteurs associés dans la commune de Natitingou en 2016. MÉTHODES: Il s'agissait d'une étude transversale à caractère analytique. L'enquête s'est déroulée en octobre 2016 et a porté sur un échantillon de 270 sujets. Elle a été menée selon une technique de sondage aléatoire à plusieurs degrés. Les données collectées ont été analysées avec le logiciel R. RÉSULTATS: Sur les 270 sujets interrogés, 72,2 % étaient des hommes. L'âge moyen était de 30,7 ± 9,2 ans. La prévalence de la co-consommation était de 33,7 % [IC95% : 28,1 %-39,7 %]). Les facteurs associés à la co-consommation d'alcool et de tabac étaient : le sexe masculin (ORa = 2,1 ; p = 0,023), la dipsomanie (ORa = 1,4 ; p = 0,032), le fait d'avoir des amis buveurs ou fumeurs (ORa = 2,8 ; p = 0,004), le fait de suivre les publicités des médias sur les boissons alcoolisées (ORa = 1,9 ; p = 0,029) et le faible coût /accessibilité des deux substances (ORa = 2,1 ; p = 0,011). CONCLUSION: Cette étude a montré qu'il est important de dépasser la prévention centrée sur la personne qui consiste à sensibiliser et à prendre en charge pour adopter des mesures de prévention structurelle (notamment législatives).

[Fever and malaria in children under 5 years of age in Benin: do we have accurate statistics?]. / Fièvres et paludisme chez les enfants de 0 à 5 ans au Bénin: avons-nous de vraies statistiques?

INTRODUCTION: In Benin, mothers generally seek health care for their children with fever and malaria only when complications appear, including severe anemia, convulsions, and coma. Statistics from the national health system are based on consultations at national health care centers and do not take into account existing cases in the community. OBJECTIVES: To determine the prevalence of malaria from the analysis of subjects with fever and their management in two participating villages. This evaluation--and a better approach to fighting childhood malaria--rely on habits of management and care-seeking and the extent of parental participation. METHODS: Parents in two villages were interviewed about their practices in managing fever in children and about active malaria screening. RESULTS: The prevalence of (thick smear-positive) malaria was the same in both villages (p>0.05). Parents brought children to health centers for consultation in only 6% of the cases of fever. Treatment was administered immediately within 48 hours for most children (75%) but only 15% received adequate anti-malarial treatment. DISCUSSION: Care-seeking is highly associated with perceptions and representations of childhood fever: for every case treated at the health centre, 16 remain in the community. CONCLUSION: Adequate management of fever and the malaria often associated with it requires understanding the perceptions and representations of parents, which will make it possible to learn the true proportion of malaria in fevers in the two villages and thus to apply appropriate strategies.

[Perceptions of parental participation by health professionals in childhood malaria control in Benin]. / Perceptions de la participation des parents par les professionnels de santé a la lutte contre le paludisme de l'enfant au Bénin.

The aim of this study was to explore and document the perceptions of health professionals regarding parental participation in the fight against child malaria, specifically with regard to fever management, in Benin (West Africa). The findings indicate that community participation in Malaria control in general, and in the case of children in particular, is essential due to the contributing factors surrounding the disease. This form of participation is different from the one recommended and practiced within the structure of the National Health system. Deep-seated, thorough reform of health care program planning is necessary in order to contribute to the improvement of the population's participation in this process. The concept of health promotion was used to frame and shed light on the analysis of the proposed recommendations. Parents' participation, one that integrates their perceptions and depictions of child fever, is not currently a reality in Benin; the study revealed that the participants seek out and request the development of skills necessary that could enable them to better contribute to the fight against malaria.

[Analyze of the performance of procurement and distribution system of antiretroviral, antituberculosis and antimalarials drugs in Benin in 2016]. / Analyse de la Performance du Système D'Approvisionnement et de Distribution des Antirétroviraux, Antituberculeux et Antipaludiques au Bénin en 2016.

OBJECTIVE: We aimed to analyze the performance of procurement and distribution system of antiretroviral, antituberculosis and antimalarial drugs in Benin. METHODS: We carried out a cross-sectional study in 2016. Data on the procurement, storage and distribution of drugs were collected by either individual interview or observation of storage sites at the central procurement center for essential medicines (CAME) in Benin. Compliance with the norms of the procurement and distribution of the products was appreciated. At the operational level, order satisfaction, drug expiry and stock status of the targeted health programs were measured based on the participants statements. RESULTS: Three workers of the CAME and 76 of health programs were surveyed. According to the norms, malfunctioning impaired the system of the procurement, storage and the distribution of the products. At the operational level, our study participants reported that antiretroviral drug orders were satisfied in 83%, drugs were distributed within three months of their expiration date in 26- 33%, and the CAME often ran out of antiretroviral drugs (stock-outs)in 69%. CONCLUSION: Malfunctioning impaired the system of the procurement, storage and the distribution of antiretroviral, antimalarial and antituberculosis drugs. These dysfunctions negatively affect the performance of the system.

OBJECTIF: Analyser la performance du système d'approvisionnement et de distribution des antirétroviraux, des antituberculeux et des antipaludiques au Bénin. MÉTHODES: L'étude transversale descriptive a été menée en 2016. Les informations sur l'approvisionnement, le stockage et la distribution des médicaments ont été collectées par entretien et observation des lieux de stockage à la centrale d'achat des médicaments essentiels (CAME). La conformité aux normes des composantes du système d'approvisionnement, de stockage et de distribution des produits a été appréciée. La satisfaction des commandes, la péremption des médicaments et l'état des stocks ont été évalués. RÉSULTATS: Trois responsables de la CAME et 76 acteurs des programmes de santé ont participé à l'étude. Des dysfonctionnements par rapport aux normes ont été notés dans les composantes du système d'approvisionnement, de stockage et de distribution des produits. Au niveau opérationnel, les commandes d'antirétroviraux étaient satisfaites selon 83% des enquêtés, les médicaments distribués étaient à moins de trois mois de la date de péremption selon 26 à 33% des participants et les ruptures de stocks d'antirétroviraux étaient signalées par 69%. CONCLUSION: Le système d'approvisionnement et de distribution des antirétroviraux, antipaludiques et antituberculeux comporte des dysfonctionnements qui impactent négativement sa performance.

[Childhood fever in a zone of malaria prevalence in Benin: qualitative analysis of factors linked to seeking care]. / Fièvre chez l'enfant en zone d'endémie palustre au Bénin: analyse qualitative des facteurs associés au recours aux soins.

In Benin, mothers usually go to health facilities when childhood malaria is already in its late stage (severe anaemia, convulsions, unconsciousness). This study was undertaken in a rural area of Benin through a community-based participation action-research aiming to control child malaria with a focus on parental participation. The aim of this research was to better understand the situation with regards to parents' perceptions and perspectives of childhood fever, care seeking behaviour and practices as well as factors that influence the choice of treatment among the various options. The parents were interviewed individually and in focus groups. Care seeking behaviour is strongly influenced by perceptions and personal opinions of childhood fever, which is considered as commonplace and not warranting care in a health centre. Severe malaria cases are perceived as a manifestation of the "bad eyes" and health facilities are consulted only as a last resort. Adequate child malaria control programmes must involve parents in order to take into account their perceptions of the implications of childhood fever.

Social inequalities in health from Ottawa to Vancouver: action for fair equality of opportunity.

The authors set out to show that the Ottawa Charter of 1986 has not been sufficiently accepted over the past twenty years, even by those who use it as a strategic tool to guide interventions for reducing social inequalities in health. Although some public health policies do emphasize the reduction of social inequalities in health, only the Ottawa Charter appears to possess the status of an international declaration on the matter. Social inequalities in health are the systematic, avoidable, and unjust differences in health that persist between individuals and sub-groups of a population. Four examples from the field of health promotion serve to show that forgetting to combat social inequalities in health is not exclusive to the domain of public health. However, taking action against social inequalities in health does not equal tackling poverty. Moreover, intervening on the principle of equality of opportunity, on the basis of an ideology of meritocracy, or for the benefit of the population as a whole, without regard to sub-groups, only tends, at best, to reproduce inequalities. Although evidence is insufficient, there are studies that show that reducing social inequalities in health is not an aporia. Three explanations are advanced as to why social inequalities in health have been ignored by health promotion professionals. The Ottawa Charter had the merit of highlighting the struggle against social inequalities in health. Now, moving beyond the declarations, from the strategic framework provided by the Ottawa Charter and in accordance with the Bangkok Charter, it is time to show proof of voluntarism. Several priorities for the future are suggested and the International Union for Health Promotion and Education (IUHPE) should be responsible for advocating for them.

[Towards a new strategy in the fight against smoking in Africa]. / Vers une nouvelle stratégie de lutte contre le tabagisme en Afrique.

Today, the fight against smoking is a vital concern as the epidemic continues to grow along with the heavy consequences, and given in particular that those who are exposed are not only the smokers. The entire world has become aware and recognised the harmfulness of tobacco, and a number of activities have been undertaken, among which can be found those of the International Union for Health Promotion and Education (IUHPE), supported by a wide range of partners. This activity which is primarily aimed at Africa, allowed health professionals from Benin to organise themselves around the success of the 1st Francophone International Seminar on the growing tobacco crisis in order to build upon the foundation which was laid in Ouidah, Benin, in November 2002. They are counting on the world-wide knowledge and expertise in the domain of the fight against smoking and, more specifically, on the political will of their governmental authorities.

Child malaria in sub-saharan Africa: effective control and prevention require a health promotion approach.

Malaria remains a vital concern of child survival in sub-Saharan Africa despite the existence of effective curative and preventive measures. It is known that child malaria is underpinned by factors such as socioeconomic, cultural, environmental, and so forth, that must be considered simultaneously in order to effectively control it. This study applied to a rural community in Benin (West Africa) the Health Promotion concept (community participation and empowerment, contextualism, intersectorality, multistrategy, equity, and sustainability) to develop a program in order to control child malaria and close the gap of unsuccessful programs. The study design was a quasi-experimental pre-post conducted over a period of 27 months. As results, 80% of the community members participated in six of the seven sub-projects planned. The prevalence of fever (malaria) was significantly reduced after the intervention (p = 0.008). The recourse to adequate health care has significantly increased after the intervention (chi2 = 48.07, p = 0.000000). All these contributed to a statistically significant reduction of children deaths due to malaria (p = 0.001) in the village. Health Promotion strategies are likely to contribute to sustainable malaria programs' implementation that reduce malaria incidence and deaths in children under five.