Sante Publique最新文献

Introduction: During its first ten years (2006-2016), the government of Evo Morales led Bolivia through a wave of reforms aimed at establishing a popular nationalism, free from what it calls "Western imperialism."

Purpose of the study: This article analyzes the implementation of the decolonization process, particularly in the reproductive health sector. It highlights the effects generated on those involved and the mechanisms of appropriation and/or rejection. To do this, it focuses on three measures: the My Health program, the professionalization of traditional midwives, and the cultural adaptation of delivery rooms.

Results: While the deployment of the My Health program is developing community medicine that is appreciated by users, it is also giving rise to deep rivalries among healthcare professionals and decision-makers alike. Furthermore, when it comes to intercultural childbirth, the study reveals a lack of both supply and demand.

Conclusion: Far from reforming it structurally, the decolonization process seems to have caused a deep ideological and organizational split within the health sector. The new measures have been implemented in the form of additional, competing programs, which has caused difficulties regarding their acceptance and integration within the established healthcare system. What's more, while in its discourse the government rejects Western colonization, in practice it remains heavily dependent on international aid.

Introduction: Health promotion is a set of intersectoral actions aimed at improving the health of all individuals and at reducing health inequalities. Public health research faces the challenge of identifying the conditions necessary to develop health promotion policies at the territorial level.

Method: To identify the conditions for the development of such a policy, we studied the case of the intersectoral health promotion policy in schools in New Caledonia. Drawing on the Kingdon model adapted to public health by Ridde et al., we conducted a detailed analysis of the context, actors, and mechanisms that enabled the publication of regulatory texts and financial commitments.

Results: We noted a surge in the number of political entrepreneurs in the health and education sectors. These key actors have made health in schools a "problem" in the political sense of the term. Support from the health agency and its partners enabled credible solutions to be proposed, which, moreover, were acceptable to the institutions, in a political context conducive to reaching consensus among members of government who come from different political backgrounds.

Discussion: A window of opportunity was opened in 2016 with the convergence of three key elements: awareness of the existence of a problem, solutions and a favorable political context, and the mobilization of political actors supported by experts who were able to substantiate the political project.

Introduction: Migrants are people who settle in a foreign country. In 2020, the global migrant population was estimated at about 281 million. Of the patients seen by the Comité pour la santé des exilés (a French non-profit that works to improve the health of refugees), 62% report having experienced violence. Migrant women are particularly exposed to gender-based violence. Among women who have migrated from the Democratic Republic of the Congo to Cameroon, 39% report having experienced sexual violence, significantly more than the rate among the host population (3.9%).

Purpose of the study: To analyze the impact of violence on the physical and mental health of migrant women consulting primary health care centers in Paris.

Methods: This was a cross-sectional analytical study carried out in two Parisian outpatient clinics. Migrant women were interviewed about whether they had experienced violence prior to their arrival in France. Their medical history and current state of health were also analyzed in light of the violence experienced.

Results: 131 migrant female patients were included over a period of three weeks. They were mainly from sub-Saharan Africa (75%), with an average age of 43 years, and 59% of them had experienced violence. Post-traumatic stress disorder (PTSD) was found in 66% of patients who had experienced violence, and half had symptoms of depression or anxiety, while these symptoms were only present in 22% and 20% respectively of migrant women in the group that had not experienced violence. Furthermore, among the patients who had experienced violence, 48% had cardiac symptoms versus 26%, 53% had respiratory symptoms versus 20%, and 58% had gastrointestinal symptoms versus 23% (p<0.05).

Conclusions: These results indicate the need for particular vigilance regarding the history of violence in the migrant population, due to an increased risk of post-traumatic stress disorder frequently associated with physical symptoms.