Sante Publique最新文献

{"title":"Analyse de l’introduction du financement basé sur les résultats et son apport au Burkina Faso.","authors":"Seydou Traoré, Samira Guennif, Léon G Blaise Savadogo","doi":"10.3917/spub.252.0219","DOIUrl":"https://doi.org/10.3917/spub.252.0219","url":null,"abstract":"<p><strong>Introduction: </strong>Results-based financing (RBF) was presented by its advocates as an effective tool for improving Burkina Faso's health care system, and an essential step toward implementing universal health coverage (UHC) in the country. It was initially introduced in 2011, and suspended in 2018.</p><p><strong>Purpose of the study: </strong>Using a conceptual framework built around the triptych of the causes, mechanisms, and outcomes of institutional change, we sought to understand how RBF was introduced in Burkina Faso, and how it contributed to the country's drive to implement UHC.</p><p><strong>Results: </strong>RBF was perceived as an external policy, essentially advocated by the World Bank. It relied on a group of actors operating outside the organizational structure of the Ministry of Health. Its impact on health indicators and the health care system has been mixed, and it has not enabled the country to put itself on a path to implementing UHC. It was not adopted by the key actors in the health care system, which is why it was discontinued without being rolled out at the national level.</p><p><strong>Conclusions: </strong>This study highlights the need to take the local context into account when designing and implementing health care programs.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 2","pages":"219-227"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usages numériques pour l’exercice physique pendant et après le confinement. Une recherche à méthode mixte.","authors":"Gonzalo Marchant, Bastien Soulé, Natacha Heutte","doi":"10.3917/spub.252.0019","DOIUrl":"https://doi.org/10.3917/spub.252.0019","url":null,"abstract":"<p><strong>Objective: </strong>To determine the reasons for using a digital exercise tool during lockdown, and change in this use after lockdown.</p><p><strong>Methods: </strong>This study followed 196 individuals during and after lockdown. An online questionnaire collected quantitative and qualitative data. The quantitative data included closed-ended questions evaluating factors influencing the use of digital tools for exercising, digital tool usage, physical activity levels, and sitting time. The qualitative data comprised open-ended questions about the reasons for digital tool usage, taking a \"multiple-lives\" perspective by examining continuity, change of tool, discontinuous use, or stopping use.</p><p><strong>Results: </strong>The quantitative data showed that digital tool users were young adults with a high level of education. Half of these individuals used a digital tool for the first time during lockdown. Post-lockdown, about 82% of the participants stopped using digital tools. The perceived usefulness of these tools during the COVID-19 period was a key driver of usage. The qualitative data revealed that the primary reasons for using digital tools during lockdown were the need for expert advice and programs, and a lack of motivation for home-based exercise.</p><p><strong>Conclusions: </strong>The closure of sports facilities during lockdown produced a substantial shift toward the use of digital technologies for maintaining physical activity. However, as the lockdown measures were relaxed, usage of these technologies declined. This underscores the importance of further scrutinizing the quality and effectiveness of these tools, many of which are freely available, in order to ensure their suitability for public health and fitness programs.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 2","pages":"19-30"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficience et productivité des établissements publics hospitaliers en Algérie.","authors":"Ahcene Ouali, Ahcène Zehnati, Martine Audibert","doi":"10.3917/spub.252.0089","DOIUrl":"https://doi.org/10.3917/spub.252.0089","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the technical efficiency and change in productivity of 120 public hospitals (établissements publics hospitaliers, EPH) in Algeria over the period 2011-2020, along with the factors influencing this efficiency.</p><p><strong>Methods: </strong>To measure efficiency scores, we used the output-oriented data envelopment analysis (DEA) method, based on the hypothesis of variable returns to scale. We also used the Malmquist index to assess changes in efficiency and productivity over the years, and the Simar-Wilson model to assess the determinants of efficiency.</p><p><strong>Results: </strong>The average efficiency scores for the study period were 0.788 and 0.710 in the classic DEA and bootstrap DEA models, respectively. Regarding the Malmquist index, we observed a 3% decline in total factor productivity during the study period, but an improvement in technical efficiency of 0.3%. As for the determinants of efficiency, six variables (bed occupancy rate, average length of stay, number of beds per doctor, number of beds per thousand inhabitants, number of doctors per thousand inhabitants, and budget) were significant.</p><p><strong>Conclusion: </strong>The results show an overall improvement in the technical performance of public hospitals during the study period. However, a decline in total factor productivity was observed over the same period, mainly due to technological change.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 2","pages":"89-99"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connaissances, attitudes et pratiques du matériel d’ostéosynthèse chez les usagers du service de chirurgie au Centre Hospitalier Régional (CHR) de Dédougou (Burkina Faso).","authors":"Abdramane Berthe","doi":"10.3917/spub.251.0225","DOIUrl":"https://doi.org/10.3917/spub.251.0225","url":null,"abstract":"<p><strong>Introduction: </strong>Osteosynthesis materials (OSM) are raising concerns among patients and medical staff, influencing attitudes and practices related to their use. Research in sociology and anthropology on these materials is limited, justifying a study of the knowledge, attitudes, and practices (KAP) of users of the surgical department at the Regional Hospital Center (CHR) of Dédougou (Burkina Faso).</p><p><strong>Methods: </strong>This is a descriptive cross-sectional mixed-methods study. A sample of 310 users was selected for the administration of a digital questionnaire. Semi-structured interviews with 51 individuals explored detailed perceptions and experiences concerning osteosynthesis materials (OSM). The data were analyzed using QDA Miner, with strict adherence to ethical principles.</p><p><strong>Results: </strong>The majority of users (63%) had heard of OSM, mainly from informal sources, but only 53% understood its advantages and disadvantages. Attitudes were predominantly positive, with 82% willing to use OSM if necessary, although 18% expressed reluctance due to high costs and cultural prejudices. Nearly 29% of users had experienced a fracture, with 50% having been offered OSM. Effective communication between caregivers and patients is crucial to improving the understanding and acceptance of OSM.</p><p><strong>Conclusion: </strong>The study highlights the need to strengthen communication and education strategies for better understanding of OSM. Efforts should include policies to make OSM financially accessible, integrate cultural concerns into care planning, and improve the training of healthcare professionals.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"225-237"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manifestations cutanées de la trypanosomiase humaine africaine gambiense (THA).","authors":"Ansoumane Kourouma, Mamadou Camara, Mariama Layba Camara, Mamadou Baïlo Diallo, Omar Camara, Moïse Kagbadouno, Bruno Bucheton","doi":"10.3917/spub.251.0173","DOIUrl":"https://doi.org/10.3917/spub.251.0173","url":null,"abstract":"<p><strong>Introduction: </strong>Cutaneous manifestations of HAT are common and often go unrecognized by healthcare providers. The objective of this research was to describe the epidemiological, therapeutic, and progressive aspects of the cutaneous manifestations of HAT.</p><p><strong>Patients and methods: </strong>This is an ambispective, descriptive, and analytical study of HAT patients presentingcutaneous manifestations, treated and monitored at the center from 01/01/2018 to 12/31/2023. The variables analyzed were epidemiological, clinical, paraclinical, therapeutic, and progressive.</p><p><strong>Results: </strong>The prevalence of cutaneous signs was 67.9%, and the most represented data were: the age group ≥ 20 years (74.4%) with a sex ratio of 1.31; activities with lower risk of HAT (58.4%), passive patients (55.2%); patients in phase II (99.2%), pruritus (100%) of severe intensity (50%), scratching lesions (78.4%) localized on the thorax (82.6%), upper (75 .5%) and lower (54.1%) limbs, and abdomen (50.9%); therapeutic abstinence (82.4%), and the association of other dermatological diseases (23.2%). The average evolution of skin signs was six months, and on average after two months 96.7% of the patients monitored were completely cured. The factors significantly associated with scratching lesions in multivariate analysis were thoracic location (p: 0.0006), age group from 0 to 19 years (p: 0.03), activities with a higher risk of HAT (p: 0.03), and leukorachia ≥100cel/μl (p: 0.01).</p><p><strong>Conclusion: </strong>Scraping lesions on the thorax are highly indicative of HAT.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"173-181"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doubles Perspectives : analyse des interventions des assistants sociaux auprès des femmes victimes de violence conjugale.","authors":"Laila Mrabti, Zouhair Belamfedel Alaoui","doi":"10.3917/spub.251.0141","DOIUrl":"https://doi.org/10.3917/spub.251.0141","url":null,"abstract":"<p><strong>Objective: </strong>This study assesses the effectiveness of psychosocial interventions by social workers in the Integrated Units for the Care of Women and Children Victims of Violence (UIPFEVV) in Morocco by examining their impact, as well as the organizational structures and operational processes involved. It also explores institutional and social power dynamics, as well as cultural influences affecting service delivery to better understand the mechanisms of response to domestic violence.</p><p><strong>Methods: </strong>A qualitative exploratory approach was adopted, including semi-structured interviews with 13 social workers and 10 victims of domestic violence in the Fès-Meknès region. Data were analyzed using inductive thematic analysis, employing the Donabedian Model to evaluate the quality of care and feminist critical theory to examine the institutional and cultural structures of care.</p><p><strong>Results: </strong>The study identifies five main themes regarding social workers' interventions: improving reception and confidentiality, empathy and interview techniques, balancing administrative and emotional support, challenges in orientation and referral, and gaps in post-intervention follow-up. The results show efforts to create a safe and empathetic environment, but also highlight challenges related to resource allocation, personalized support adaptation, and maintaining a continuous relationship with the victims. The Donabedian Model helped identify strengths and weaknesses in structures and processes, while feminist critical theory revealed systemic imbalances affecting the quality of services.</p><p><strong>Conclusions: </strong>The study emphasizes the need to adapt interventions to the cultural and personal contexts of victims to enhance service effectiveness. It recommends enhanced professional training, better resource allocation, and the implementation of rigorous follow-up protocols to adequately meet the needs of women victims of domestic violence. These adjustments are essential to ensure continuous and effective support, thus facilitating recovery and well-being for victims, while taking into account the institutional and power dynamics influencing these interventions.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"141-150"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recrutement actif de seniors socio-économiquement défavorisés pour des ateliers de prévention : la procédure INVITE.","authors":"Clélia M Bianchi, Aurélie Bocquier, Chloé Cogordan, Hélène Tréhard, Mélissa Badiou, Dolorès Nadal, Julie Dessirier, Guillaume Briclot, Christelle Trotta, Christophe Dubois, Pierre Verger, Nicole Darmon","doi":"10.3917/spub.251.0089","DOIUrl":"https://doi.org/10.3917/spub.251.0089","url":null,"abstract":"<p><strong>Introduction: </strong>The risk of aging in poor health is greater among disadvantaged people, but they benefit less from health prevention actions focused on diet and physical activity.</p><p><strong>Purpose of the study: </strong>The INVITE research-action aims to [1] develop an active recruitment procedure to encourage older adults identified as disadvantaged to attend diet and physical activity prevention workshops in the French region Provence-Alpes Côte d'Azur (PACA), [2] evaluate the feasibility and acceptability of this procedure, and [3] measure the effective participation in the workshops of the identified older adults.</p><p><strong>Results: </strong>The INVITE procedure was co-developed by researchers, social workers, and older adults. It includes six steps: identification, invitation letter, telephone contact, home visit, phone call confirmation, and welcome session during the workshop. A pre-test phase made it possible to identify the barriers facing older adults and their motivations at each step, and thus to improve the procedure. The evaluation phase of the effective participation showed that, for 9 workshops, 47 home visits were carried out and 11 older adults participated in the workshops.</p><p><strong>Conclusion: </strong>The INVITE procedure is well received and makes it possible to reach out to disadvantaged older adults and bring them to prevention workshops. Since the prevention workshops promote social diversity, this procedure could be an effective lever to avoid widening social inequalities in health. A larger-scale deployment would help to better characterize participants' sociodemographic profiles and to evaluate costs.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"89-99"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postures communicationnelles des spécialistes en médecine générale dans le dépistage familial du cancer colorectal.","authors":"Griselda Drouet, Fabienne Moreau, Nicolas Palierne, Pierre Ingrand, Aline Delsart, Elisabeth Richard, Isabelle Ingrand","doi":"10.3917/spub.252.0101","DOIUrl":"10.3917/spub.252.0101","url":null,"abstract":"<p><strong>Introduction: </strong>First-degree relatives (FDRs) of patients with colorectal cancer (CRC) or advanced adenoma before the age of 65 (index patients) are at increased risk of CRC, but the guidelines for family screening of FDRs by colonoscopy are poorly followed. The aim of this study was to describe the involvement of primary care physicians (PCPs) with patients (relatives at high risk of colorectal cancer or index patients) and their communicative stance in the context of family screening in relation to the various people involved (other physicians, index patients, and relatives).</p><p><strong>Method: </strong>The study was based on 29 semi-structured telephone interviews with French PCPs of index patients and/or their FDRs. The fully transcribed corpus of interviews was put through linguistic analysis using a lexicometric tool to identify discourse objects based on frequency calculations, and for the purposes of thematic sociological analysis.</p><p><strong>Results: </strong>The analyses showed that family screening is conditioned by communication between PCPs and index patients, whom they encourage to pass on the guidelines to their relatives, and by conversations with doctors from other specialisms, who provide them with precise information about the diagnosis. FDRs have a more \"classic\" relationship with their PCPs, who ask questions in order to ascertain the patient's history and thus direct them toward appropriate screening. The stance of PCPs thus seems to alternate between supervision and reflection, and between consultation and questioning.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 2","pages":"101-113"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Les professionnels de santé assurant le suivi gynécologique en France : différents profils d’activité.","authors":"Thomas Karnycheff, Guillaume Chevillard, Sandrine Voillequin, Quitterie Roquebert","doi":"10.3917/spub.252.0127","DOIUrl":"https://doi.org/10.3917/spub.252.0127","url":null,"abstract":"<p><strong>Introduction: </strong>In France, gynecological care is provided by three types of health professionals: gynecologists, primary care physicians, and midwives. The objective of this study was to describe the gynecological care provided by these different health professionals at the national level.</p><p><strong>Methods: </strong>A descriptive and analytical study of indicators of gynecological care (cervical and vaginal swabs, contraception procedures, and initial contraception and preventive consultations) by gynecologists, primary care physicians, and midwives in private practice in 2022, using data from the French National Health Data System (SNDS) to establish profiles of health professionals using multivariate analysis (principal component analysis and hierarchical clustering).</p><p><strong>Results: </strong>Three gynecologist profiles, five primary care physician profiles, and four midwife profiles were identified based on the intensity of their gynecological care activity and their specialization in certain types of procedures. Professionals with significant gynecological care activity often have a particular focus on private practice, are more frequently female, and belong to younger age groups. The geographical distribution of professionals with significant gynecological care activity varies according to the profession.</p><p><strong>Conclusion: </strong>We demonstrate significant heterogeneity in gynecological care, both between different types of professionals and within the same profession. Understanding gynecological care provision and its dynamics thus requires us to take into account the variety of actors at both the inter- and intra-professional levels.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 2","pages":"127-144"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Déterminants du comportement d’Activité Physique chez les survivantes du cancer du sein participant au programme RIPOSTE : une étude qualitative utilisant le cadre des domaines théoriques.","authors":"Sabrine Hasnaoui, Mathias Poussel, Andreia Carvalho de Freitas, Laetitia Ricci, Abdou Omorou, Aurélie Van Hoye","doi":"10.3917/spub.251.0151","DOIUrl":"https://doi.org/10.3917/spub.251.0151","url":null,"abstract":"<p><strong>Introduction: </strong>Despite strong evidence of the benefits of physical activity on reducing the side effects of breast cancer and associated treatments, many patients tend to be physically inactive. Understanding the facilitators and barriers to their engagement in physical activity and their continuation of it represents a first step toward designing targeted interventions to increase this activity. The aim of this study is to describe the determinants of the physical activity behavior of patients participating in the RIPOSTE program.</p><p><strong>Method: </strong>A qualitative study was conducted with ten patients undergoing invasive breast cancer surgery and participating in an adapted physical activity program based on fencing (RIPOSTE). Semi-structured interviews explored their physical activity experience and were analyzed both inductively and deductively using the Theoretical Domains Framework, examining mechanisms of behavior change.</p><p><strong>Results: </strong>Fifty-six themes were identified as facilitators and barriers in twelve of the fourteen domains. The \"Environmental Context and Resources\" and \"Social Influences\" domains were the most predominant. The \"Social/Professional Role and Identity,\" \"Optimism,\" and \"Reinforcement\" domains were not mentioned by all participants.</p><p><strong>Conclusion: </strong>Use of the Theoretical Domains Framework enabled the study to highlight the complexity of physical activity behavior change among cancer survivors. Our results provided a useful theoretical basis to guide the selection of modifiable factors when designing interventions to improve patients' physical activity levels.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"37 1","pages":"151-171"},"PeriodicalIF":0.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}