The article analyzes health systems in West Africa and proposes actions to improve their efficiency. He noted the progress made, although hampered by conflicts and health crises like Ebola. States are struggling to finance their health systems, leading to inequalities in access to care. WATHI recommends five areas of action: strengthening prevention, training and better distributing health professionals, improving sector financing, optimizing the daily management of health infrastructures and developing research and regional cooperation. Emphasis is placed on the need for citizen and political commitment for sustainable reforms, taking into account the limited resources of the countries concerned.

Politics, Political party, State, Natural ressources, Education, Gold, Health, Soicial sciences, Researh, Knowlege production

The article examines the communication challenges faced by Ghanaian health professionals when treating French-speaking refugees, particularly Ivorians who arrived in Ghana following the political crises of 2010-2011. These refugees are mainly housed in Ampain, Egyeikrom and Fetentaa camps. The language barrier between English-speaking medical staff and French-speaking patients compromises the quality of care. The authors recommend training in medical French for Ghanaian health staff, the development of an adapted bilingual curriculum and immersion internships in French-speaking countries, such as Côte d'Ivoire. They also propose the training of specialized medical interpreters to facilitate interactions when direct communication is difficult. These measures aim to improve patient-physician communication and ensure quality care for French-speaking refugees in Ghana.

Culture, Health, refugee

The Groupe URD (2023) article analyses the obstacles hindering access to reproductive health care for Chadian adolescent girls. Health infrastructure, often dilapidated and poorly located, discourages its use by young people. Social norms and suspicions surrounding premarital sexuality dissuade adolescent girls from seeking contraceptive services, for fear of being stigmatized. The rate of contraceptive use remains low, with only 8 to 9% of women of reproductive age using it. Early pregnancies are common, partly due to child marriage. Illegal abortions, often carried out in unsafe conditions, lead to serious complications. Gender-based violence is widespread, with one in three women having suffered physical violence since the age of 15. The HIV prevalence rate is 1.2%, with HIV positivity higher among women, particularly adolescent girls.

Governance, Gender, Education, Health

The article “Malnutrition at the heart of the One Health approach” highlights the importance of nutrition within the framework of the One Health approach, which integrates human, animal and environmental health. It notes that the number of undernourished people is increasing, with 70 million people suffering from hunger in West Africa. Malnutrition particularly affects pregnant women and children, leading to reduced immunity and increased child mortality. Climate change is exacerbating these challenges by disrupting food systems. The article calls for concerted action to strengthen food and nutrition security, taking into account the interactions between human, animal and environmental health, in order to effectively address current health challenges.

Climate change, Food security, Health

The “2024-2027 Roadmap for Strengthening the Inclusion of Refugees in the National Health System in Mauritania” aims to fully integrate refugees into the Mauritanian health system. It is part of the country’s commitment to ensuring refugees’ access to health services, in line with the Sustainable Development Goals and the National Health Development Plan 2021-2030. Key objectives include strengthening health infrastructure, improving the supply of essential medicines, and gradually integrating refugees into the national health insurance system.

Governance, Health, refugee

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