Thirty years after the Beijing Declaration, this report highlights the continued marginalization of African women with disabilities in public policy and feminist movements. Despite legal frameworks like the CRPD and the African Disability Protocol, implementation remains weak. Based on consultations with 244 women across 23 countries, the report reveals deep-rooted, intersectional discrimination: extreme poverty, specific forms of gender-based violence, political underrepresentation, economic exclusion, and barriers to healthcare and education. Most policies lack an intersectional lens and disaggregated data, limiting effective action. This participatory report calls for the recognition of disabled women as change-makers and provides concrete recommendations for their full inclusion. It emphasizes the urgency of integrating their voices in decision-making spaces to achieve genuine gender equality.

Health, Violence, Discrimination, Inclusive education, Inclusion, Socio-economic integration

Despite improvements in certain indicators, the Nigerien healthcare system remains precarious and dominated by a logic of "inhospitable medicine." This fragility is largely explained by the predominance of intervention mechanisms and public policies largely dictated and funded by international donors, often far removed from local dynamics and the operational realities of healthcare services. However, in this constrained context, certain structures stand out for the quality of the care they provide. They are unique in that they are led by committed local actors, true "shadow reformers," who design pragmatic and contextually adapted solutions to daily dysfunctions. Based on an ethnographic investigation, this article examines the logics of innovation at work in these marginal spaces of transformation. Drawing on operational research, it argues for recognition and increased support for these bottom-up reform dynamics, which are likely to constitute a credible alternative – or at least a necessary complement – ​​to conventional approaches to improving health systems.

Politics, Governance, Public Administration, Health, Réforme, Politique publique

Despite some improvements, Niger's healthcare system remains fragile, characterized by "unwelcoming medical practices." Reform policies, often funded by international aid, struggle to adapt to the local realities of healthcare services. However, some facilities are providing better quality care thanks to "local reformers" who develop innovative solutions adapted to daily challenges, despite precarious working conditions. This article analyzes these local innovations using ethnographic data and proposes to explore "bottom-up" approaches to reforming the healthcare system, in addition to current strategies.

Governance, Public Administration, Health, Politique publique, Healthcare system

The Multisectoral Surveillance Bulletin for the Timbuktu and Taoudénni regions (Mali) for October-November 2024 highlights several major concerns: floods that have destroyed irrigated agricultural areas, rising rice prices, and an unstable security situation with 78 incidents reported (+21.87% compared to the previous two-month period). The agricultural situation is marked by a delay in off-season crops due to flooding. Livestock farming is improving thanks to sufficient pastureland in Timbuktu, although less favorable in Taoudénni. Access to water for livestock is generally satisfactory. Fisheries production is declining due to rising water levels. Acute malnutrition remains a concern, particularly affecting children and requiring an urgent response. Displaced populations continue to increase due to conflict, reaching 42,785 in Timbuktu and 2,899 in Taoudénni.

Culture, State, Natural ressources, Education, Family, Gold, Health, Fishing, Marché, Malnutrition

This article examines the effectiveness, attractiveness, and sustainability of social insurance mechanisms in rural Senegal, particularly through mutual health insurance schemes. Although Universal Health Coverage (CMU) relies on these mutual health insurance schemes to provide coverage to vulnerable populations, several obstacles hinder their success: difficulties in collecting contributions, delays in government payments, and heavy administrative burdens. The study aims to identify the determining factors of their operation and to explore the expansion of services to other risks (disability, death, retirement). A mixed survey was conducted, involving 1,565 participants. The results show that membership is based on financial and health motivations, but that the viability of mutual health insurance schemes requires better governance and diversified financing. Recommendations are made to improve their effectiveness and attractiveness.

Politics, Political party, Power, State, Natural ressources, Education, Gold, Social, Health, Knowlege production

The article “An Unequal Partnership? The Partnerships of International NGOs at the Local and National Levels” examines the relationships between international NGOs (INGOs) and national NGOs (NNGOs) in Côte d'Ivoire, focusing on the health sector, particularly cervical cancer prevention. The study highlights the tensions and asymmetries in these partnerships, which are often imposed by INGOs on local actors. While INGOs provide financial and technical support, NNGOs struggle with a lack of autonomy and recognition. The research also emphasizes the increasing bureaucratization of projects, the weak involvement of local partners in decision-making, and the impact of partnerships on local NGO governance. Despite mutual benefits, the authors conclude that these collaborations remain unbalanced and require adjustments to ensure more equitable and effective development.

Power, Economic Development, Natural ressources, Education, Gold, Health, Civil Society, Soicial sciences, Researh, Knowlege production

The article analyzes the adoption and adaptation of the CMAM Surge model in Niger. Introduced in 2014, this model aims to improve the health system's response to malnutrition cases. Although deployed in 434 health facilities, its application remains heterogeneous. The study identifies the major challenges of its implementation: lack of knowledge of the program by health workers, poor training, coordination problems with NGOs and lack of resources. The Surge approach, initially designed to manage malnutrition crises, encounters difficulties in sustainable integration. Some local reform actors are more successful in adapting it, by involving communities more and developing alternative strategies. The article offers a critical analysis of the strengths and weaknesses of the model and explores ways to strengthen its appropriation and impact.

Natural ressources, Justice, Education, Gold, Health, Civil Society, Soicial sciences, Researh, Knowlege production, Malnutrition

In the interview titled "The State Must Provide the Necessary Means for Research," Dr. Hamidou Lazoumar Ramatoulaye, an epidemiologist and researcher at the Center for Medical and Health Research (CERMES) in Niger, emphasizes the crucial importance of adequate research funding for national development. She highlights the essential role of research in improving health systems and promoting the well-being of populations. Dr. Ramatoulaye stresses the need for the state to invest more in research infrastructures, researcher training, and the creation of partnerships with international institutions. She also advocates for better valorization of research results so they can be practically applied in public policies and medical practices. According to her, without strong state commitment to supporting research, it would be challenging to address the health challenges facing Niger.

Governance, Health, Researh, Funding

The article entitled “Evaluation of the provision of care in emergency situations based on the establishment of advanced health posts in the town of Djibo, Burkina Faso, April 2022” analyzes the effectiveness of advanced health posts (PSAs) deployed in Djibo in response to an emergency situation in April 2022. The study examines how these PSAs improved access to health care for the local population in crisis situations. The results indicate increased use of health services and better accessibility for residents, thus contributing to a more effective health response in emergency contexts.

Governance, Health, Politique publique, Emergency, Accessibility