Introduction: The health of mothers and children remains a major concern in developing countries. Infant and maternal mortality rates, although declining, are still high. Access to health services is a major obstacle ...Introduction: The health of mothers and children remains a major concern in developing countries. Infant and maternal mortality rates, although declining, are still high. Access to health services is a major obstacle to reducing maternal and infant mortality. To support the Ministry of Health and Social Action in the implementation of its Strategic Plan for Reproductive Health (2012-2015), the NGO Micronutriment Initiative has developed a project based on community-based maternal and neonatal health services (CBMNHS) in the Kolda region. The general objective of this study is to collect the perceptions of the actors on the Community-Based Maternal and Neonatal Health Services project in the Kolda and Sedhiou regions. Method: This was a qualitative study consisting of an evaluation of the activities carried out within the framework of the CBMNHS project at the level of the intervention zone. The study focused on support groups, community actors, post nurses and implementers of the intervention. Sampling was comprehensive for community actors and nurse heads. Focus groups and in-depth individual interviews were used to assess the perceptions of women and support groups, as well as to better understand the dynamics of the intervention. The content analysis was performed to exploit the qualitative data. Results: All local and national health authorities interviewed are unanimous about the relevance of the project. The project’s strategies are essentially community-oriented. Thus, a large number of committees have been set up. A total of 1258 support groups were set up during the project, distributed as follows: 260 grandmother groups (Grandmothers Strategy);266 groups of pregnant women (Pregnant Women’s Solidarity Circles);248 Care Group;468 community watch and alert circles and 16 Future Fathers’ Groups (Future Fathers’ Solidarity Circles). These committees aimed to involve women of reproductive age, mothers, mothers-in-law and fathers. More than 70% of women surveyed agree that support groups have improved their knowledge of maternal health, nutrition, and children’s health. Groups also improved their attendance at health facilities, which is a major asset of the project. Conclusion: The analysis of the perception of the different actors of the CBMNHS project shows that the project is well conducted in the area of intervention that is the region of Kolda. However, the central question of the success of sustainability is the existence of a withdrawal plan. Indeed, this plan must be studied from the very beginning and must be adapted to the local context. As a result, support groups are urged to become more involved in reproductive health activities, especially those related to the exclusive breastfeeding, and to continue to provide all forms of support (financial and moral) to women of reproductive age for reproductive health carrying out reproductive health activities for better access to services.展开更多
Introduction: Anemia in women of reproductive age is a common health problem in the region of Kolda (Senegal). The objective of this research was to study the risk factors of anemia among women in reproductive age in ...Introduction: Anemia in women of reproductive age is a common health problem in the region of Kolda (Senegal). The objective of this research was to study the risk factors of anemia among women in reproductive age in Kolda (Senegal). Methodology: A cross-sectional, descriptive and analytical study of women in reproductive age and their households was conducted in the Kolda region between October and December 2015. This was a three-stage random sample survey. The data was collected during an individual interview. Logistic regression was used to identify the factors of this anemia. Results: In this study, 968 women of reproductive age were surveyed. The average age of women was 27 years with a standard deviation of 7.4 years. There were 10% of pregnant women, 36.3% of lactating women and 53.7% of women neither pregnant nor lactating. The average size of the households surveyed was 14 people and the 36.3% had an average economic level. The majority of households were equipped with traditional latrines (76.9%). Women were neither pregnant nor lactating in 53.7%, were uneducated in 70.7% and 81% used micronutrient-rich foods. The prevalence of anemic women was 55.2%. The factors associated with anemia in women in Kolda were the use of traditional latrines (ORa = 1.48 [1.0 - 2.1]), the woman’s pregnancy status (ORa = 5 [2.7 - 9.8]), non-education of the woman (ORa = 1.52 [1.1 - 2.0]), the existence of income-generating activity for the woman (ORa = 0.69 [0.5 - 0.9]), the processing of local products in the household (ORa = 0.5 [0.3 - 0.9]) and the use of at least one micronutrient rich food in the household (ORa = 0.73 [0.49 - 1.0]). Conclusion: The prevalence of anemia among women in reproductive age is still high in the Kolda region. To combat this phenomenon, awareness campaigns on iron and folic acid supplementation should be stepped up, the use of modern latrines should be promoted and the empowerment of women should be strengthened.展开更多
Objectives: To evaluate the epidemiology of eclampsia, to assess maternal and perinatal prognosis and management. Material and method: This was a retrospective, descriptive study from January 1, 2015 to December 31, 2...Objectives: To evaluate the epidemiology of eclampsia, to assess maternal and perinatal prognosis and management. Material and method: This was a retrospective, descriptive study from January 1, 2015 to December 31, 2018. Included were all women received in the emergency department of our health facility for generalized seizures and/or disturbances of consciousness, occurring between the 20th Week of Amenorrhea (WA) and the 6th week of postpartum on a field of hypertension. The sources of the data consisted of antenatal consultation cards, delivery records, hospital records, operating theater and resuscitation records. The variables studied were sociodemographic characteristics, the course of pregnancy, childbirth and neonatal parameters. Data were captured and analyzed using SPSS 11.0 software. Results: The study focused on 190 cases with a prevalence of 3.5%. The average age of the patients was 20 years with extremes of 14 and 40 years. The average parity was 4.1 deliveries with extremes of 1 and 7. Nearly three-quarters of the patients (74.7%) of the patients were primiparous. Almost all the patients were evacuated. More than half of the seizures (53.1%) were recorded before work and more than one out of two patients had two seizures. Caesarean section was the mode of delivery in more than one out of two patients (56.8%). Maternal complications were marked by renal failure (23 cases), the HELLP syndrome (72 cases), and the retro placental hematoma (83 cases). The fetal impact was marked by prematurity in 90% of cases and 17 cases of fetal death in-utero. Nineteen maternal deaths were recorded while early neonatal mortality was 437 per 1000 live births. The average hospital stay of the survivors was 6.2 days. Conclusion: Eclampsia is still common in our regions. It occurs preferentially in young primiparas with hypertension and/or proteinuria on a poorly followed pregnancy. Magnesium sulphate and cesarean section can improve the maternal and fetal prognosis. Prevention necessarily means quality prenatal care.展开更多
Introduction: Lack of dietary diversity is a nutritional problem among poor people in developing countries whose daily diet is usually based on a starch source with one or two additional components. Senegal has food i...Introduction: Lack of dietary diversity is a nutritional problem among poor people in developing countries whose daily diet is usually based on a starch source with one or two additional components. Senegal has food insecure regions such as Kolda and Kedougou despite improved agricultural production. This study aims to investigate the determinants of dietary diversity in the Kolda and Kedougou regions. Methodology: It was a cross-sectional, descriptive and analytic household-level study in two southern regions of Senegal (Kolda and Kedougou) between October and December 2015. This was a three-stage random sample survey. Dietary diversity in women of reproductive age was measured using the Women’s Dietary Diversity Score (WDDS) recommended by Food and Agriculture Organization of the United Nations (FAO). The WDDS is a global qualitative indicator of nutrition, which counts the number of food groups consumed by a person in the 24 hours preceding the survey. The data was collected during an individual interview. Linear regression was used to identify the associated factors of dietary diversity. The free and informed consent of the individuals surveyed and the protection of anonymity were respected. Results: A total of 1926 women were surveyed. The mean of WDDS was 2.9 with a standard deviation of 1.4. The Kedougou department has a better WDDS with 3.3 (±1.2) followed by the Kolda department with a score of 3.2 (±1.3). The higher the household’s welfare score, the better the WDDS with a ßcoefficient of 0.11 [0.09 - 0.13]. Households that are in urban areas have a better score than households in rural areas (0.27 [0.13 - 0.41]). The improvement of knowledge in food diversification, in good culinary practice improves the dietary diversity score in women. Conclusion: The WDDS is low in the southern regions of Senegal. To improve dietary diversification in this area, the practice of good cooking practices, the accessibility of micronutrient-rich foods, and the decision-making power of women in the household should be promoted.展开更多
Objectives: To study the epidemiological profile and the prognosis of the retro-placental hematoma (HRP) at the maternity ward at Kolda Regional Hospital Center. Materials and methods: This was a retrospective descrip...Objectives: To study the epidemiological profile and the prognosis of the retro-placental hematoma (HRP) at the maternity ward at Kolda Regional Hospital Center. Materials and methods: This was a retrospective descriptive cross-sectional study conducted over a period of 11 years: from January 1st, 2006 to December 31st, 2016, at Kolda Regional Hospital Center. It included all patients admitted for HRP during this period. The studied parameters concerned sociodemographic characteristics, gynecological obstetrical history;clinical, therapeutic and prognostic data (non-inclusion or exclusion criteria). The data were collected from medical records, the delivery room and the surgery room registers using a collection sheet developed for this purpose. The statistical analysis of the variables studied was done with the software Epi-info 3.5. For the qualitative variables, we calculated the frequencies and for the quantitative variables, we studied the distributions. Results: During the study period, 15,343 were recorded deliveries and we carried out the diagnosis of HRP in 301 patients (1.97%). The average age of the patients was 24 years with an average parity of 4.8 deliveries. Almost all the patients (87.5%) were evacuated and half had delivered by caesarean section. Maternal and fetal deaths were 7% and 72.1%, respectively. Uterine atony accounted for 21.2% of complications. One third of the cases of uterine atony had resulted in a hysterectomy. The average duration of hospitalization was 6 days. Conclusion: The retro-placental hematoma is a serious medico-obstetric emergency. It is burdened with high maternal and fetal morbidity and mortality in developing countries.展开更多
文摘Introduction: The health of mothers and children remains a major concern in developing countries. Infant and maternal mortality rates, although declining, are still high. Access to health services is a major obstacle to reducing maternal and infant mortality. To support the Ministry of Health and Social Action in the implementation of its Strategic Plan for Reproductive Health (2012-2015), the NGO Micronutriment Initiative has developed a project based on community-based maternal and neonatal health services (CBMNHS) in the Kolda region. The general objective of this study is to collect the perceptions of the actors on the Community-Based Maternal and Neonatal Health Services project in the Kolda and Sedhiou regions. Method: This was a qualitative study consisting of an evaluation of the activities carried out within the framework of the CBMNHS project at the level of the intervention zone. The study focused on support groups, community actors, post nurses and implementers of the intervention. Sampling was comprehensive for community actors and nurse heads. Focus groups and in-depth individual interviews were used to assess the perceptions of women and support groups, as well as to better understand the dynamics of the intervention. The content analysis was performed to exploit the qualitative data. Results: All local and national health authorities interviewed are unanimous about the relevance of the project. The project’s strategies are essentially community-oriented. Thus, a large number of committees have been set up. A total of 1258 support groups were set up during the project, distributed as follows: 260 grandmother groups (Grandmothers Strategy);266 groups of pregnant women (Pregnant Women’s Solidarity Circles);248 Care Group;468 community watch and alert circles and 16 Future Fathers’ Groups (Future Fathers’ Solidarity Circles). These committees aimed to involve women of reproductive age, mothers, mothers-in-law and fathers. More than 70% of women surveyed agree that support groups have improved their knowledge of maternal health, nutrition, and children’s health. Groups also improved their attendance at health facilities, which is a major asset of the project. Conclusion: The analysis of the perception of the different actors of the CBMNHS project shows that the project is well conducted in the area of intervention that is the region of Kolda. However, the central question of the success of sustainability is the existence of a withdrawal plan. Indeed, this plan must be studied from the very beginning and must be adapted to the local context. As a result, support groups are urged to become more involved in reproductive health activities, especially those related to the exclusive breastfeeding, and to continue to provide all forms of support (financial and moral) to women of reproductive age for reproductive health carrying out reproductive health activities for better access to services.
文摘Introduction: Anemia in women of reproductive age is a common health problem in the region of Kolda (Senegal). The objective of this research was to study the risk factors of anemia among women in reproductive age in Kolda (Senegal). Methodology: A cross-sectional, descriptive and analytical study of women in reproductive age and their households was conducted in the Kolda region between October and December 2015. This was a three-stage random sample survey. The data was collected during an individual interview. Logistic regression was used to identify the factors of this anemia. Results: In this study, 968 women of reproductive age were surveyed. The average age of women was 27 years with a standard deviation of 7.4 years. There were 10% of pregnant women, 36.3% of lactating women and 53.7% of women neither pregnant nor lactating. The average size of the households surveyed was 14 people and the 36.3% had an average economic level. The majority of households were equipped with traditional latrines (76.9%). Women were neither pregnant nor lactating in 53.7%, were uneducated in 70.7% and 81% used micronutrient-rich foods. The prevalence of anemic women was 55.2%. The factors associated with anemia in women in Kolda were the use of traditional latrines (ORa = 1.48 [1.0 - 2.1]), the woman’s pregnancy status (ORa = 5 [2.7 - 9.8]), non-education of the woman (ORa = 1.52 [1.1 - 2.0]), the existence of income-generating activity for the woman (ORa = 0.69 [0.5 - 0.9]), the processing of local products in the household (ORa = 0.5 [0.3 - 0.9]) and the use of at least one micronutrient rich food in the household (ORa = 0.73 [0.49 - 1.0]). Conclusion: The prevalence of anemia among women in reproductive age is still high in the Kolda region. To combat this phenomenon, awareness campaigns on iron and folic acid supplementation should be stepped up, the use of modern latrines should be promoted and the empowerment of women should be strengthened.
文摘Objectives: To evaluate the epidemiology of eclampsia, to assess maternal and perinatal prognosis and management. Material and method: This was a retrospective, descriptive study from January 1, 2015 to December 31, 2018. Included were all women received in the emergency department of our health facility for generalized seizures and/or disturbances of consciousness, occurring between the 20th Week of Amenorrhea (WA) and the 6th week of postpartum on a field of hypertension. The sources of the data consisted of antenatal consultation cards, delivery records, hospital records, operating theater and resuscitation records. The variables studied were sociodemographic characteristics, the course of pregnancy, childbirth and neonatal parameters. Data were captured and analyzed using SPSS 11.0 software. Results: The study focused on 190 cases with a prevalence of 3.5%. The average age of the patients was 20 years with extremes of 14 and 40 years. The average parity was 4.1 deliveries with extremes of 1 and 7. Nearly three-quarters of the patients (74.7%) of the patients were primiparous. Almost all the patients were evacuated. More than half of the seizures (53.1%) were recorded before work and more than one out of two patients had two seizures. Caesarean section was the mode of delivery in more than one out of two patients (56.8%). Maternal complications were marked by renal failure (23 cases), the HELLP syndrome (72 cases), and the retro placental hematoma (83 cases). The fetal impact was marked by prematurity in 90% of cases and 17 cases of fetal death in-utero. Nineteen maternal deaths were recorded while early neonatal mortality was 437 per 1000 live births. The average hospital stay of the survivors was 6.2 days. Conclusion: Eclampsia is still common in our regions. It occurs preferentially in young primiparas with hypertension and/or proteinuria on a poorly followed pregnancy. Magnesium sulphate and cesarean section can improve the maternal and fetal prognosis. Prevention necessarily means quality prenatal care.
文摘Introduction: Lack of dietary diversity is a nutritional problem among poor people in developing countries whose daily diet is usually based on a starch source with one or two additional components. Senegal has food insecure regions such as Kolda and Kedougou despite improved agricultural production. This study aims to investigate the determinants of dietary diversity in the Kolda and Kedougou regions. Methodology: It was a cross-sectional, descriptive and analytic household-level study in two southern regions of Senegal (Kolda and Kedougou) between October and December 2015. This was a three-stage random sample survey. Dietary diversity in women of reproductive age was measured using the Women’s Dietary Diversity Score (WDDS) recommended by Food and Agriculture Organization of the United Nations (FAO). The WDDS is a global qualitative indicator of nutrition, which counts the number of food groups consumed by a person in the 24 hours preceding the survey. The data was collected during an individual interview. Linear regression was used to identify the associated factors of dietary diversity. The free and informed consent of the individuals surveyed and the protection of anonymity were respected. Results: A total of 1926 women were surveyed. The mean of WDDS was 2.9 with a standard deviation of 1.4. The Kedougou department has a better WDDS with 3.3 (±1.2) followed by the Kolda department with a score of 3.2 (±1.3). The higher the household’s welfare score, the better the WDDS with a ßcoefficient of 0.11 [0.09 - 0.13]. Households that are in urban areas have a better score than households in rural areas (0.27 [0.13 - 0.41]). The improvement of knowledge in food diversification, in good culinary practice improves the dietary diversity score in women. Conclusion: The WDDS is low in the southern regions of Senegal. To improve dietary diversification in this area, the practice of good cooking practices, the accessibility of micronutrient-rich foods, and the decision-making power of women in the household should be promoted.
文摘Objectives: To study the epidemiological profile and the prognosis of the retro-placental hematoma (HRP) at the maternity ward at Kolda Regional Hospital Center. Materials and methods: This was a retrospective descriptive cross-sectional study conducted over a period of 11 years: from January 1st, 2006 to December 31st, 2016, at Kolda Regional Hospital Center. It included all patients admitted for HRP during this period. The studied parameters concerned sociodemographic characteristics, gynecological obstetrical history;clinical, therapeutic and prognostic data (non-inclusion or exclusion criteria). The data were collected from medical records, the delivery room and the surgery room registers using a collection sheet developed for this purpose. The statistical analysis of the variables studied was done with the software Epi-info 3.5. For the qualitative variables, we calculated the frequencies and for the quantitative variables, we studied the distributions. Results: During the study period, 15,343 were recorded deliveries and we carried out the diagnosis of HRP in 301 patients (1.97%). The average age of the patients was 24 years with an average parity of 4.8 deliveries. Almost all the patients (87.5%) were evacuated and half had delivered by caesarean section. Maternal and fetal deaths were 7% and 72.1%, respectively. Uterine atony accounted for 21.2% of complications. One third of the cases of uterine atony had resulted in a hysterectomy. The average duration of hospitalization was 6 days. Conclusion: The retro-placental hematoma is a serious medico-obstetric emergency. It is burdened with high maternal and fetal morbidity and mortality in developing countries.
