The 2023 Sectoral Review of the Ministry of Health of Mauritania reports on progress towards universal health coverage, in line with the National Health Development Plan (PNDS) 2022-2030. It highlights advances in human resources, infrastructure, equipment and health financing, with activities such as capacity building of personnel and construction of health structures. However, challenges persist, particularly in terms of availability of medicines and governance of the health system. The review recommends better coordination with technical and financial partners, improvement of monitoring mechanisms and optimization of the use of data for decision-making. The outlook includes continued efforts to strengthen the health system and achieve the objectives of the PNDS, with an emphasis on the effectiveness of interventions and the mobilization of necessary resources.

Governance, Health, Couverture sanitaire

West and Central Africa (WCA) have a predominantly young population, with 64% under the age of 24. By 2030, the adolescent population (10-19 years) is projected to increase by 37%, from 120 million to 164 million. This demographic trend presents an opportunity for a demographic dividend, provided that young people are educated, healthy, and have access to decent employment. However, significant challenges persist, including limited access to quality education, high dropout rates, gender-based violence, and early unintended pregnancies. In response, representatives from 17 countries issued the Dakar Call in 2015, affirming their political commitment to youth. In November 2018, a regional conference brought together over 120 representatives from 22 countries to discuss the links between sexual and reproductive health, education, and school dropout. Priorities identified include combating early pregnancies, child marriages, HIV, sexually transmitted infections, substance abuse, and sexual violence. To harness the potential of this youth, it is essential to strengthen educational and health policies, focusing on gender equality and protection against violence.

Governance, Education, Health

According to an Afrobarometer survey published in August 2023, Mauritanians consider education (42%), health (42%), and poverty (40%) as the main problems that the government must address. More than half of citizens (55%) have sought health care in the past 12 months, while 33% have used public education services. Access to education is considered easy by 80% of respondents, but access to medical care is divided (51% easy versus 49% difficult). Corruption remains an obstacle, with 43% of users having paid bribes to obtain identity documents, and around 30% to access health, police, or education services. Citizens express general dissatisfaction with government performance in maintaining infrastructure and providing basic services, including health, education, and drinking water.

Bribery, Education, Public Administration, Poverty, Health, Services publics

The mission report of the Assistance Publique des Hôpitaux de Paris (APHP), carried out from February 26 to March 3, 2023, aims to improve the care pathway for vulnerable patients at the Outpatient Treatment Center (CTA) in Nouakchott and to strengthen the skills of caregivers for monitoring specific populations. The objectives include the promotion of sexual health, screening and treatment of sexually transmitted infections (STIs), as well as the prevention of cervical cancer and mother-to-child transmission of infections. The report highlights low overall health coverage in Mauritania, with only 60% of women giving birth in health facilities and vaccination coverage of around 60%. HIV prevalence is estimated at 0.29%, stable for ten years, except in Chami where an increase in the population has been observed. In gynecology/obstetrics, the National Hospital Center of Nouakchott (CHNN) has 50 beds and records 3,800 deliveries per year, with a cesarean rate of 37%, which is constantly increasing.

Governance, Public Administration, Health, Couverture sanitaire

The article "Environment and Diseases in the Sahel (West Africa). Between Two Worlds" examines the interaction between environmental conditions and disease prevalence in the Sahel region. It highlights that the Sahel, located between the Saharan and Sudanese climates, is a convergence zone for various epidemics. Diseases vary according to the seasons and the lifestyles of the populations: nomadic pastoralists and sedentary farmers are not affected in the same way. For example, the "lean cow" period for pastoralists, corresponding to the end of the dry season, differs from the "empty granaries" period for farmers. This complex dynamic between environment and public health makes disease management particularly difficult in this region.

Agriculture, Pastoralism, Climate change, Health

Burkina Faso is facing a severe food crisis, exacerbated by violence perpetrated by armed groups that have displaced nearly one and a half million people, mainly women and children. This situation has led to widespread food insecurity, jeopardizing the health and survival of many families. Terre des hommes (Tdh) is responding by providing emergency aid while continuing its actions aimed at strengthening the resilience of affected populations. The organization is setting up health and nutrition programs for children and mothers, offering psychosocial support to victims of violence, and working to improve sanitation conditions and access to drinking water. Tdh is also working with local communities to develop sustainable solutions to this humanitarian crisis.

Governance, Agriculture, Pastoralism, Natural ressources, Food security, Women, Health, Violence