Sante Publique最新文献

{"title":"Un aperçu de l’état de la santé mentale et des perceptions des services offerts auprès d’une communauté noire francophone d’Ottawa : une étude transversale.","authors":"Saredo Mohamed Bouraleh, Mwali Muray, Nadine Ngwaka, Hélène Archambault, Anifa Luyinga Kalay, Raymond Tempier, Marie-Hélène Chomienne","doi":"10.3917/spub.hs1.2026.0083","DOIUrl":"10.3917/spub.hs1.2026.0083","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to assess the self-reported mental health among Ottawa&amp;#8217;s French-speaking Black community in Canada by identifying associated sociodemographic factors, with the goal of informing public health interventions. Our study draws on three theoretical frameworks: public mental health, psychosocial determinants of health, and intersectionality. These frameworks allow us to examine how social determinants and social identities influence mental health status and access to services among Francophone Black individuals living in a linguistic minority context in Ottawa.</p><p><strong>Methodology: </strong>This is a cross-sectional study conducted among adults (&amp;#8805;18 years) who identify as members of the Black Francophone community and reside in Ottawa. Data were collected between June 2023 and December 2024 using an online questionnaire. Sociodemographic variables, self-reported mental health status, and perceptions of healthcare needs and access were assessed. Analyses included descriptive statistics and intergroup comparisons.</p><p><strong>Results: </strong>A total of 126 Black French-speaking individuals in Ottawa completed the questionnaire. Of these, 40.6% reported poor self-perceived mental health. Participants with poor mental health were predominantly women (76.9%), young adults (43.6% aged 18&amp;#8211;19; 41.0% aged 20&amp;#8211;29) and single individuals (70.6%). Perceived stress varied significantly according to mental health status (p &amp;lt; 0.0001), with those reporting poorer mental health more frequently reporting high or extreme stress.</p><p><strong>Discussion: </strong>The results highlight significant disparities in mental health and perceived stress within this population, reflecting the influence of intersecting social and demographic factors. These findings underscore the need to consider relevant cultural and linguistic determinants when addressing mental health inequalities.</p><p><strong>Conclusion: </strong>These findings demonstrate the urgent need to adapt public health policies and interventions to the cultural and linguistic realities of this population. Such an approach is essential to ensure equitable access to mental health care.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 HS1","pages":"83-97"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867480","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":"<i>Quand les armes se taisent, la musique parle</i>, Quentin Dabe , Éditions L’Harmattan, coll « Psycho Logique », Paris, 2025.","authors":"Laurence Fond-Harmant","doi":"10.3917/spub.263.0361","DOIUrl":"https://doi.org/10.3917/spub.263.0361","url":null,"abstract":"","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 3","pages":"361-362"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117380","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":"Educational investment as a lever for longevity: An econometric analysis of life expectancy at birth in the Democratic Republic of the Congo","authors":"Kifweta Kizabi Michel Zongwe, Mohamed Chamsoudine Pountougnigni, Adolphe Kasongo Bin Zongwe, Héritier Heshemu Katebula","doi":"10.3917/spub.263.0297","DOIUrl":"10.3917/spub.263.0297","url":null,"abstract":"<p><strong>Introduction: </strong>Education is a major determinant of human development and may influence health through improved knowledge, income, access to care and preventive behaviors. This study examines the long-term association between public education expenditure and life expectancy at birth in the Democratic Republic of the Congo (DRC).</p><p><strong>Method: </strong>The analysis uses annual data covering the period 1996&amp;#8211;2022. The variables are drawn from the World Development Indicators, the Worldwide Governance Indicators, the KOF Globalisation Index, and annual reports of the Central Bank of Congo. After unit-root and cointegration tests, long-run relationships are estimated using FMOLS and CCR methods, distinguishing total, female and male life expectancy at birth.</p><p><strong>Results: </strong>The results show a positive and statistically significant association between public education expenditure and life expectancy at birth. A 1% increase in public education expenditure is associated with a 0.0038% increase in total life expectancy, with gender-differentiated effects: 0.0006% for women and 0.0051% for men. Political stability and urbanization also show positive coefficients, whereas infant mortality, CO2 emissions, and unemployment are negatively associated with life expectancy.</p><p><strong>Discussion: </strong>The observed association confirms the importance of educational investment as a social determinant of health, but it should be interpreted with caution. The estimates indicate a long-run correlation rather than a strict causal effect. The smaller estimated coefficient for women may reflect structural constraints limiting the translation of education into health gains.</p><p><strong>Conclusion: </strong>Public investment in education appears to be a complementary lever for improving longevity in the DRC. Its potential effects could be strengthened through integrated policies addressing infant mortality, employment, infrastructure, institutional stability, and gender equity.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 3","pages":"297-308"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117612","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":"Effects of the COVID-19 crisis on mental health and health care pathways","authors":"Maylis Sposito-Tourier, Caroline Doucet, Cynthia Morgny, Céline Leclerc, Claire Cherbonnet, Arthur Guérin-Turcq, Bérénice Lambert","doi":"10.3917/spub.263.0165","DOIUrl":"10.3917/spub.263.0165","url":null,"abstract":"<p><p>Introduction&amp;#160;: The COVID-19 crisis and successive lockdowns profoundly altered the epidemiology of mental health and patterns of care delivery. Methods&amp;#160;: This study aims to identify the profiles of patients newly receiving care for psychiatric disorders during the health crisis, to analyze changes in their trajectories and care pathways throughout the lockdown periods, and to compare them with individuals who were already receiving care prior to the pandemic. It also seeks to better understand triggering factors, mobilized resources, patterns of healthcare utilization, and coordination between professionals and care structures. A mixed-methods approach was used: A quantitative analysis of data from the French National Health Data System (SNDS) (2016&amp;#8211;2021) to identify profiles of mental healthcare utilization. A qualitative analysis based on 29 interviews with individuals aged 18&amp;#8211;24 and 50&amp;#8211;64 who experienced psychological disorders before and/or during the health crisis. Results&amp;#160;: The crisis had age-specific impacts: young people were more frequently hospitalized, whereas individuals aged 50&amp;#8211;64 showed higher use of psychotropic medications. However, these trends conceal considerable heterogeneity in care trajectories, ranging from episodic care to long-term follow-up. Interviews reveal that the crisis acted as a catalyst for psychological disorders and social vulnerabilities, particularly among young adults but also among those aged 50&amp;#8211;64. Discussion&amp;#160;: The results show both a reorganization of care provision and healthcare utilization during the pandemic, as well as a diversity of trajectories shaped by age, prior medical history, and available resources. Moreover, the onset of disorders and engagement with care pathways do not always coincide with periods of strict lockdown. Conclusion&amp;#160;: The health crisis highlighted, and often amplified, latent psychological and social vulnerabilities within the population.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 3","pages":"165-176"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117446","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":"Coding of female genital mutilation in the French Program for Medical Information Systems (PMSI): Why and how to improve accuracy?","authors":"Delphine Hascoet, Ruth M'bwang-Seppoh, Pascal Inizan","doi":"10.3917/spub.263.0075","DOIUrl":"10.3917/spub.263.0075","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to analyze the coding practices of female genital mutilation (FGM) within the French Program for Medical Information Systems (PMSI) in order to identify current limitations and their impact on care classification and healthcare funding.</p><p><strong>Methods: </strong>A mixed-methods approach was adopted, combining a qualitative analysis based on a semi-structured interview with a specialist physician and an exploratory quantitative analysis based on a questionnaire distributed to Medical Information Departments (DIM). Data analysis relied on descriptive and comparative methods.</p><p><strong>Results: </strong>All surveyed Medical Information Departments use the ICD-10 code N90.8 to code FGM as the principal diagnosis. However, practices vary significantly regarding associated diagnoses and surgical procedures. The lack of harmonization in coding practices, as well as limited awareness of specific funding mechanisms, restricts access to dedicated financial support for FGM management.</p><p><strong>Conclusion: </strong>This study highlights the urgent need to improve FGM coding within the PMSI through the adoption of more specific codes. Better data structuring and traceability would improve recognition of care needs and facilitate access to funding mechanisms such as MIGAC and MERRI, thereby enhancing the quality of care provided to patients.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 3","pages":"75-86"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117488","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":"Intégrité scientifique, intelligence artificielle et sécurité de la recherche.","authors":"Frédéric Denis","doi":"10.3917/spub.262.0007","DOIUrl":"https://doi.org/10.3917/spub.262.0007","url":null,"abstract":"","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 2","pages":"7-9"},"PeriodicalIF":0.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989848","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":"Mobiliser les populations migrantes ou précaires pour des approches collectives de promotion de la santé.","authors":"Laure Hermet, Antoine Plaux, Christian Pradier","doi":"10.3917/spub.262.0119","DOIUrl":"10.3917/spub.262.0119","url":null,"abstract":"<p><strong>Introduction: </strong>Access to healthcare for migrant and socially vulnerable populations remains marked by significant inequalities. Collective health approaches, defined as interventions bringing together several individuals around shared health issues (information workshops, group discussions, prevention or health promotion activities), are recognized as an important lever for health promotion. However, their implementation among these populations remains challenging. The aim of this study was to explore health perceptions among migrant patients attending a M&amp;#233;decins du Monde center and to identify barriers and facilitators to their participation in collective health activities.</p><p><strong>Methods: </strong>An exploratory qualitative study was conducted at the M&amp;#233;decins du Monde Health and Orientation Centre (CASO) in Nice. Twenty-one exploratory interviews and eight semi-structured interviews were conducted with French-speaking migrant patients until data saturation was reached. Interviews were recorded, transcribed, and analyzed using a thematic approach. Partial double coding was performed using NVivo software.</p><p><strong>Results: </strong>Participants displayed contrasting perceptions of health, ranging from a central life priority to a secondary concern behind housing, employment, or administrative regularization. Physicians were perceived positively as central figures of care and protection. Interest in collective activities appeared heterogeneous: Some participants viewed them as an opportunity for sharing, while others expressed reluctance. Several barriers were identified, including language barriers, constraints related to informal work, fatigue, community tensions, and the absence of cultural mediators.</p><p><strong>Discussion: </strong>Engaging migrant patients in collective health approaches requires specific conditions, including long-term implementation, co-construction with participants, involvement of peers, and consideration of their life priorities. This exploratory study identifies key feasibility conditions and provides a basis for the design of pilot interventions, whose evaluation and impact indicators will need to be defined at a later stage.</p><p><strong>Conclusion: </strong>Collective approaches to health can be a relevant lever for reducing inequalities in access to care, provided they are adapted to the social constraints and life priorities of migrant and socially vulnerable populations.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 2","pages":"119-128"},"PeriodicalIF":0.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989796","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":"Vers une oppression de l’éducation à la sexualité : une comparaison du contenu de deux manuels de sciences.","authors":"Ange Maïn-Ndeiang Laoungang, André Wamba","doi":"10.3917/spub.262.0041","DOIUrl":"10.3917/spub.262.0041","url":null,"abstract":"<p><strong>Background: </strong>Sex education is a vital part of the curriculum and plays an important role in the physical and mental development of children and young adolescents. But children&amp;#8217;s and young adolescents&amp;#8217; access to sex-related knowledge is a controversial issue and a source of social tension.</p><p><strong>Purpose: </strong>The study examines science textbooks using the conceptual framework of oppression to expose the systemic oppression affecting learners&amp;#8217; ability to access, acquire, and understand knowledge about sexuality.</p><p><strong>Methods: </strong>We used a qualitative method, based on the content analysis. The content of the textbooks served as the data source and the main assessment instrument was UNESCO&amp;#8217;s assessment guideline.</p><p><strong>Results: </strong>Results show that the textbooks were designed and provided by the educational authorities, and the topics and content about sexuality covered by the textbooks were very limited, leading to learners&amp;#8217; oppression by hindering their access to sexual knowledge.</p><p><strong>Conclusions: </strong>By recognizing the oppression of sexual knowledge, educators can adopt alternative approaches that challenge systemic oppression in the textbooks.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 2","pages":"41-52"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989592","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":"Facteurs associés à l’équité vaccinale à Madagascar : analyse des disparités et voies d’intervention en santé publique.","authors":"Hery Sylvestre Bemanana","doi":"10.3917/spub.262.0247","DOIUrl":"10.3917/spub.262.0247","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to analyze factors associated with vaccine equity among children aged 12-23 months in Madagascar.</p><p><strong>Methods: </strong>Data from the 2021 Madagascar Demographic and Health Survey were analyzed using descriptive and multivariate approaches. Variables included residence (urban/rural), maternal education, birth order, possession of a health card, and economic quintile. Associations were assessed using chi-square tests and logistic regression.</p><p><strong>Results: </strong>Overall vaccine coverage was 48.5% (95% CI = 46.4-50.5), higher in urban areas (58.4%) than rural areas (46.6%). Major disparities were observed according to maternal education (76.6% for educated mothers vs. 29.3% for uneducated) and birth order (56.1% for firstborns vs. 40.0% for birth order ≥4). Logistic regression showed that maternal education (OR = 5.6), birth order (OR = 2.3), and possession of a health card (OR = 0.1) were significantly associated with vaccine coverage.</p><p><strong>Discussion: </strong>Persistent social, economic, and geographic inequities continue to limit vaccine coverage. Targeted strategies, supported by digital tracking systems and adapted to local contexts, are essential to improve equitable access to vaccination services. Continuous evaluation and regular adjustment of interventions will be critical to ensure sustainable progress.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 2","pages":"247-260"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989785","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":"Gouvernance de l’achat stratégique de la santé en Afrique : une revue de la littérature.","authors":"Seyni Mbaye, Ibrahima Seck","doi":"10.3917/spub.262.0269","DOIUrl":"10.3917/spub.262.0269","url":null,"abstract":"<p><strong>Introduction: </strong>Strategic purchasing for health care is a key mechanism for improving the effectiveness, equity, and efficiency of health systems by directing resources toward priority outcomes. Unlike passive purchasing, it channels funding toward high-impact interventions to support universal health coverage (UHC). Governance plays a critical role in ensuring transparent decision-making aligned with national health priorities.</p><p><strong>Methods: </strong>This literature review draws on the Strategic Purchasing Africa Resource Center&amp;#8217;s (SPARC) strategic purchasing progress-tracking framework to analyze governance practices in Africa, focusing on Burkina Faso, Kenya, Nigeria, Morocco, and Tunisia. It examines key governance dimensions, including decision-making, autonomy, health information systems, stakeholder engagement, and transparency in resource allocation.</p><p><strong>Results: </strong>Common challenges across these countries include fragmented decision-making processes, unclear institutional roles, weak regulatory oversight, and inadequate health information infrastructure, which limits data-driven decision-making. Transparency in resource allocation&amp;#8212;essential for building trust and ensuring efficiency&amp;#8212;remains limited in most cases.</p><p><strong>Discussion: </strong>To strengthen strategic purchasing, governments must address governance challenges, enhance regulatory frameworks, invest in robust health information systems, and promote greater transparency. These measures will improve resource allocation and foster stakeholder confidence in health financing mechanisms.</p>","PeriodicalId":49575,"journal":{"name":"Sante Publique","volume":"38 2","pages":"269-279"},"PeriodicalIF":0.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989791","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}