This cross-sectional study assesses the quality of maternal and newborn health care in Niger using a nationally representative sample of 110 public facilities (integrated health centres, district hospitals and mother–child hospitals) and 2,153 women. A quality-of-care tool, co-developed with the Ministry of Health, combined five components: health facility survey, partograph review, healthcare provider knowledge tests, client exit interviews, and direct observation of antenatal and postnatal consultations. Findings show important structural gaps, with incomplete access to electricity, water and transport, and uneven availability of key tests and medicines. Partographs are used for most deliveries but are often poorly completed. Screening and integrated management of preeclampsia, anaemia and infectious diseases (HIV, syphilis, tuberculosis, malaria) remain suboptimal, especially in postnatal care. While overt mistreatment is rare, communication gaps are frequent: results and diagnoses are not consistently explained to women. The authors call for targeted investments in supplies, competency-based training, respectful care and stronger integration of services at each contact with pregnant and postpartum women.

Governance, Women, Health, Enfant

As of March 2022, only about 1% of Chad’s population was fully vaccinated against COVID-19, and no prior data existed on vaccine hesitancy in the country. This cross-sectional study in N’Djamena (August–October 2021) surveyed 508 adults—patients, community members and healthcare workers—using a 25-item questionnaire and an adapted WHO SAGE Vaccine Hesitancy Scale. Overall, 52% said they would accept a COVID-19 vaccine, with higher acceptance among patients (67%) than community members (44%) and healthcare workers (47%). The mean hesitancy score was 29/50, and more than one-third of respondents were classified as highly hesitant. Knowing someone who died from COVID-19, trusting the government, perceiving local healthcare worker support, having comorbidities and higher socioeconomic status (electricity at home) were all associated with lower hesitancy. Main concerns focused on side effects, efficacy, safety, the pharmaceutical industry and distrust of government. Qualitative analysis highlighted four themes: information, trust, clinical concerns, and misinformation/false beliefs.

Governance, Security, Poverty, Health

The report carried out by the Japan International Cooperation Agency (JICA) in Côte d’Ivoire assesses the country’s health sector policy aimed at achieving universal health coverage (UHC) for women, children and low-income populations. It highlights achievements but also significant barriers: regional inequalities, low public health financing, reliance on external aid, and limited access to essential services. The survey uses both quantitative and qualitative data collected from health authorities, service providers and beneficiaries. It offers recommendations to strengthen system effectiveness: enhanced coordination, sustainable resource mobilisation, improved governance, and prioritising access for vulnerable groups. Although Côte d’Ivoire has a favourable policy framework, implementation remains uneven. The report is pivotal for guiding future UHC strategies in the country.

Women, Health, Enfant, Santé publique, Protection

This article evaluates the impact of Senegal’s free health insurance programme for poor households, implemented through the National Family Security Scholarship Programme (PNBSF). Using 2019–2020 data from the rural area of Niakhar, the study assesses whether free enrollment in community-based health insurance (CBHI) improves healthcare utilisation and financial protection. Despite the programme’s intentions, the findings reveal major implementation failures: limited awareness among beneficiaries, unintentional or “virtual” enrollments, weak communication, and structural shortcomings within CBHI schemes. As a result, free insurance did not increase healthcare consultations during illness, antenatal care visits, or protection against catastrophic health expenditures. The only significant positive effect observed was an increase in facility-based deliveries. The authors conclude that the limited impact stems from implementation gaps rather than the concept of free insurance itself, stressing the need for stronger government commitment and measures to reduce barriers to accessing covered services.

Governance, Inequality, Gender, Conflict, Religious education, Education, Health, Threat, Soicial sciences, Researh, Knowlege production, Politique publique, Protection

Cross-sectional study in Dakar (December 2021) among 301 adults (20–69 years) assessed ultra-processed food (UPF) intake using NOVA and quantified contributions to NCD-related critical nutrients. UPFs provided 17.4% of total energy, 43% of free sugars, 26.9% of total fat, 24.4% of sodium and 24% of potassium. Individuals in the highest UPF tercile consumed more total energy (~1,996 kcal), total fat, free sugars, potassium and protein than those in the lowest tercile. Greater UPF share was positively associated with exceeding recommended total fat intake (OR = 2.58; p = 0.002) and negatively associated with non-recommended intakes of potassium (OR = 0.01; p < 0.001) and protein (OR = 0.43; p = 0.009). Authors conclude UPFs substantially shape diet quality in urban Senegal and may be a major determinant of NCD incidence and prevalence.

Governance, Food security, Health, Santé publique

This paper assesses Senegal’s mpox epidemiological surveillance from 14 July to 10 November 2024. Using a retrospective, cross-sectional, descriptive and analytical design, it includes all cases sampled during the period. One hundred suspected cases were reported (~6 per million), all sampled, with zero confirmations. Alternative viral diagnoses were identified in 32% (mostly varicella-zoster) and 4 co-infections were recorded (12.5%). The median time from symptom onset to result availability was 7 days; the median consultation-to-result interval was 2 days, with longer delays in remote areas. Of 48 preparedness activities, 56.25% were completed and 10.42% were ongoing. System strengths included adaptation to the IDSR kit, multi-level staff training, surveillance procedures, focal points, a diversified reference-laboratory network, and electronic case notification (DHIS2/4S). The authors call for strengthened logistics and laboratory/response capacity in border and hard-to-reach regions to reduce delays and sustain readiness.

Governance, Health, Santé publique

This study assesses the Health and Social Development Program (PADSS2) implemented in Mali’s Mopti region to improve healthcare access for pregnant women and children amid increasing terrorist attacks. Using a controlled interrupted time series analysis (2016–2021), the authors compared intervention and control districts. Results show modest but positive effects: assisted deliveries increased by 1.5%, antenatal consultations by 1–2%, and under-five child visits also rose. However, intensified terrorist activity led to a sharp decline in child consultations (up to 40%). The program’s overall impact remained below expectations due to security challenges, governance constraints, and limited implementation capacity. The authors call for stronger collaboration between donors and researchers, and better integration of security dynamics in the design and evaluation of public health interventions in fragile contexts.

Gender, Security, Conflict, Education, Human security, Influence, Health, Soicial sciences, Researh, Knowlege production, Information

The article “The Challenges of the Debate on the Decolonization of Global Health in Francophone Countries”, published in Santé Publique (Vol. 37, No. 1, 2025) by Valéry Ridde, Amandine Fillol, Fatoumata Hane, and Fati Kirakoya-Samadoulougou, examines the controversies surrounding decolonization within Francophone global health. The authors highlight the growing academic interest in this topic alongside persistent institutional resistance to questioning colonial power structures. They discuss epistemic injustices that marginalize non-Western knowledge and emphasize the need for reflexivity, relational responsibility, and cognitive justice. The editorial calls for transforming research practices, partnerships, and policies to authentically integrate Southern voices and knowledge systems, fostering more equitable and inclusive global health governance.

Natural ressources, Justice, Education, Gold, Social, Health, Soicial sciences, Researh, Knowlege production, Colonization

The book The Financialization of Health in Senegal (1840–1960), written by Valéry Ridde and published in 2025 by Éditions Science et Bien Commun (Québec), explores the evolution of health financing under French colonial rule. Drawing on extensive archival sources, Ridde reveals that colonial health systems—often depicted as humanitarian progress—were in fact marked by deep inequalities and fiscal exploitation. The study traces the origins of health financialization through patient payments, private medical practice, and limited mutual aid schemes. The Indigenous Medical Assistance (AMI), ostensibly free, imposed taxes and fees that burdened African populations. By examining budgets, hospital structures, and policy reforms, the book exposes the ideological and bureaucratic mechanisms that shaped colonial health governance and laid the groundwork for modern health inequities in Senegal.

Politics, Political party, Natural ressources, Justice, Education, Gold, Social, Health, Researh, water