Sante Publique最新文献

Introduction: Older adults were among those who suffered most from the COVID-19 pandemic. In Morocco, where 64.4 percent of older adults suffer from a form of chronic illness, the main challenge facing local authorities was how to maintain essential care for this population group in the context of the pandemic.

Purpose of the research: The aim of the study was to determine the effects of the COVID-19 pandemic on older adults’ access to primary healthcare in the Essaouira Province (Morocco), with a view to ensuring the ongoing provision of healthcare for older adults during health emergencies. A longitudinal retrospective survey was conducted from October to December 2021 based on a structured questionnaire with a sample of 196 people aged sixty and above. The data obtained were compiled and analyzed using SPSS software (version 20.0).

Results: The COVID-19 pandemic has adversely affected older adults’ access to primary healthcare. Older adults’ use of primary healthcare services fell by 51.6 percent during the pandemic compared with the same periods in previous years. In addition, the measures taken to control the pandemic have had a negative impact on the quality of services offered to the survey participants.

Conclusion: The COVID-19 pandemic resulted in significant changes in the operation of primary healthcare for older populations. The findings of this study provide a basis for anticipatory actions to improve the ongoing provision of healthcare for older adults in the context of health emergencies.

In Senegal, violent delinquency and illicit drug use are on the increase. This study focuses on two distinct groups: drug users (DUs) undergoing rehabilitation and violent ex-offenders (VEs). The methodology adopted includes a quantitative survey of the general population (n=1009), followed by a qualitative survey of fifteen participants, including eight DUs undergoing treatment at the Centre de prise en charge intégrée des addictions de Dakar (CEPIAD) (Integrated Addictions Management Center of Dakar) and the Centre Jacques Chirac de Thiaroye, and seven former VEs from the Grand Yoff district. This neighborhood, known for its violence, is juxtaposed with the Grand Yoff social housing estate, a residential area also affected by outbreaks of violence. This study aims to establish the link(s) between drug use and criminal violence by analyzing the life stories of young adults who have managed to leave drug use and delinquency behind. It then looks to identify the determinants of resilience in certain young people. The study revealed delinquent violence among young people does not systematically result from drug use. Rather, drug use is a factor conducive to violence. The links between drugs and violence depend on individual predisposition, the type of drugs used, and the level of addiction. Resilience results from a web of individual, sociocultural, and environmental factors. It is not static, but rather the result of a series of successes, failures, and even relapses.

Introduction: Health professionals’ social responsibility in health resists translation into skills that can be taught and implemented concretely in professional practice.

Purpose of the research: This study, conducted by the Réseau International Francophone pour la Responsabilité Sociale en Santé (RIFRESS), aims to develop a consensus on the components of doctors’ social responsibility in health from the perspective of experts in medical education. Its findings are intended to inform the creation of a skills profile. A three-round Delphi consensus method was used, with an open first round and closed second and third rounds. Mesydel software was used to organize the process and to do the qualitative analysis of the first round. SPSS was used for consensus analysis for rounds 2 and 3.

Results: Thirty-four experts responded to the study. During the first round, 62 codes emerged, grouped into 13 themes. From the initial analysis, 40 items were submitted for the Delphi round 2. Of these 40 items, 23 came out consensual after the second round, as did 13 of the 18 resubmitted items after the third. Examples of items that emerged as consensual are eco-responsibility, advocacy, defense of the common good, critical analysis of practice, and collaborative leadership.

Conclusions: The present study represents a much-needed effort to concretely define the components of doctors’ social responsibility in health. Local context must be taken into account when using these findings. They can help to train tomorrow’s doctors to better meet the priority health needs of society in a profoundly changing world.

Community-based research, that is, the meaningful involvement of affected populations in the production of scientific knowledge that concerns them, is a political struggle and an ethical necessity. Coalition PLUS, an international network of organizations (most of them NGOs) fighting against HIV and hepatitis, created a community-based research laboratory (CBRL) composed of people from more than sixteen countries and various disciplinary fields. The objectives of the CBLR are to build research capacity, ensure collaboration with local and international academic research centers, and develop international research projects. The CBRL acts as a bridge between different partners, reconciling sometimes divergent interests, and must provide mediation and support to promote dialogue, transparency, and a relationship of trust between the communities and academic researchers. However, the need for scientific legitimacy obliges us to continuously seek a balance between responding to the needs of the field and using rigorous scientific methods, while optimizing and prioritizing existing resources. The permanent quest for this balance has led the CBRL to reorganize its mode of operation to optimize existing synergies with academic research laboratories, with a view to asserting its scientific legitimacy and continuing to contribute to social transformation through community-based research that is both innovative and of high quality. This paper provides a critical reflection on the issues, challenges, practices, and solutions of community-based research within the Coalition PLUS network.

Introduction: The management of cardiovascular pathologies has a high cost for users.

Purpose of the research: It is therefore important to assess the costs of hospitalization to gain a better understanding of its impact on care.

Results: This was a case series-type, descriptive, observational study with prospective data collection.

Results: A total of 103 patients were included, with a mean age of 51 years and extremes ranging from 14 to 86 years. The average length of stay was 7.1 days. Heart failure was the most frequent pathology (61.7%). The average monthly income per patient was 101,360 CFA francs. The average total direct cost during hospitalization was 114,015 CFAF. The average direct cost of drugs and consumables was 60,553.77 CFAF. The average direct cost of paraclinical examinations was 34,360.29 CFAF. Hospitalization costs averaged 16,747.47 CFAF. Total direct costs during hospitalization were 11,737,060 CFAF, dominated by drugs and medical consumables (53.14%), followed by complementary examinations (29.86%) and non-medical expenses (17%). During the study, 13.59% of patients were discharged against medical advice. Expenses were covered by the parents in 71.84% of cases.

Conclusions: The average direct cost of hospitalization is well above the purchasing power of the majority of patients.

Introduction: The participatory action-research (PAR) carried out at the Lieu de Répit (LDR) (Place of Respite) accompanied the emergence of an innovative intervention model, while placing particular importance on the participation of people suffering from psychological disorders. It also produced relevant scientific results and promoted collective empowerment.

Purpose of research: The article reports on a presentation at the conference “Recherches participatives en santé et bien-être des populations: défis et pratiques” (“Participatory Research in Community Health and Well-being: Challenges and Practices”), organized by the Institut pour la recherche en santé publique (IReSP) on March 9 and 10, 2022.

Results: Three PAR actors present situated views on interpersonal relations, the organisation of PAR, and the effects of participation. Participation is facilitated by a range of contextual, human and organisational factors.

Conclusions: Although complex to implement, participatory health research is necessary for the production of new knowledge, while meeting new epistemic requirements.

Context: Sexual and gender diverse individuals (SGDI) report higher usage of methamphetamine in sexual contexts. They face difficulties making sense of their experiences and being heard in services. Peer researchers (individuals with lived experience) were involved in a participatory study on methamphetamine consumption.

Objectives: 1) To describe the opportunities and challenges of involving peer researchers in all stages of the research process; 2) To discuss how this involvement could address the epistemic injustice experienced by SGDI who practice chemsex.

Methodology: The peer-researcher participatory process was documented through a journal and meeting notes, which were analyzed through the framework of epistemic injustice. This notion refers to the mechanisms that prevent the knowledge of a person or group from being heard and considered legitimate.

Results: The contribution of peer researchers was highly valued and raised questions. Their in-depth knowledge facilitated data analysis and guided knowledge dissemination, promoting the transformation of current services. Their presence also helped to establish relationships of trust with the study population.

Discussion: This connection with the study population can create expectations for services that may require a significant level of involvement from researchers. The team’s commitment to improving services can generate a mistaken perception of a lack of objectivity.