In developing countries, treatment of uterine fibromyoma is confronted with numerous problems, namely: financial inaccessibility to the proposed treatments, fear of surgery and the weakness of the technical platform. Objectives: The objectives of the study were to calculate the frequency of uterine fibromyomas, describe the socio-demographic characteristics of patients, identify the main clinical data and to describe the modalities of surgical management. Patients and Method: It was a mixed descriptive study, cumulative over a period of 5 years (60 months) with data collection in two phases: a 4-year retrospective study from
Background Despite efforts to reduce the burden of female genital mutilation (FGM) in Guinea, the practice remains prevalent, and health care providers are increasingly being implicated in its medicalization. This formative study was conducted to understand the factors that facilitate or impede the health sector in providing FGM prevention and care services to inform the development of health sector-based interventions. Methods Between April and May 2018, a mixed methods formative study was carried out using a rapid assessment methodology in three regions of Guinea—Faranah, Labe and Conakry. A structured questionnaire was completed by one hundred and fifty health care providers of different cadres and 37 semi-structured interviews were conducted with health care providers, women seeking services at public health clinics and key stakeholders, including health systems managers, heads of professional associations and schools of nursing, midwifery, and medicine as well as representatives of the Ministry of Health. Eleven focus group discussions were conducted with female and male community members. Results This study revealed health systems factors, attitudinal factors held by health care providers, and other factors, that may not only promote FGM medicalization but also impede a comprehensive health sector response. Our findings confirm that there is currently no standardized pre-service training on how to assess, document and manage complications of FGM nor are there interventions to promote the prevention of the practice within the health sector. This research also demonstrates the deeply held beliefs of health care providers and community members that perpetuate this practice, and which need to be addressed as part of a health sector approach to FGM prevention. Conclusion As integral members of FGM practicing communities, health care providers understand community beliefs and norms, making them potential change agents. The health sector can support them by incorporating FGM content into their clinical training, ensuring accountability to legal and policy standards, and promoting FGM abandonment as part of a multi-sectoral approach. The findings from this formative research have informed the development of a health sector intervention that is being field tested as part of a multi-country implementation research study in Guinea, Kenya, and Somalia.
Older people are a demographically significant group, who represent a vulnerable layer within conditions for active and healthy aging that may be lacking in both urban and rural areas. Objective: To identify the main barriers and opportunities for the establishment of age-friendly cities and communities in a low-income country. Methods: This was a qualitative study that involved focus group discussions with older people, and service providers (health and social services) in the city of Conakry. The older people were purposively selected with the support of older people associations, and men and women were equally represented in the sample. Results: The analysis focused on the experience of old age as well as the barriers and opportunities for active healthy aging specific to the sub-Saharan context. The results indicate that a good quality of life for older adults boils down to the acquisition of good health and decent housing. Other concerns frequently reported were food and education problems for their children and security. Conclusion: This study contributes to strengthening the understanding of the age-friendly cities and communities' approach in the context of sub-Saharan African countries.
Perineal trauma is a non-surgical solution of continuity of posterior perineal committing under the effect of a violent exertion during childbirth. It occurs at the time of disengagement, either from the head or the posterior shoulder. Objectives: To calculate the perinea trauma during childbirth, describe the socio demographic profile of the women in childbed, identify contributory effects and appreciate the maternal prognostic. Methodology: It was a prospective study, descriptive type of 6 months (from May 19 to November 20, 2014). It took place at the maternity ward of Donka National Hospital. It concerned all received parturient, women in bed of a single fetus in the unit and having had a perineum traumatism. The real ones were epidemiologic, therapeutic clinical and prognostic. Results: We have recorded 110 perinea traumatism cases over 3496 childbirth let say a frequency of 3%. The socio demographic profile of the woman who did perinea traumatism was a teenager (42.7%), professional occupation (29.1%), married (88.2%), schooled, secondary and Technical level (42.7%), primary (70%) having had more than 3 prenatal consultations (73.6%). Contributory effects were: prim parity, young age, instrumental extraction by obstetrical forceps and the fetal weight between 2500 to 3999 g. Surgical management was (100%). The following were simple in 88.2% cases versus 11. 8% of complications. Conclusion: The reduction of this frequency requests systematical practice and corrects recentered prenatal consultations and the respect of episiotomy indications.
Tubal ligation is a surgical sterilization procedure that provides permanent and reliable contraception to women. Tubal obstruction is a method of permanent birth control that can be performed after mini-laparotomy under local anesthesia. Objective: To determine the outcome of tubal sterilizations by mini-laparotomy under local anesthesia performed in clients who underwent the surgical operation in the Maternity Ward of Ignace Deen National Hospital. Patients and Methods: The Gynecology and Obstetrics Department of Ignace Deen National Hospital was used as the place for the study. The study involved all the women seeking voluntary surgical contraception. This was a retrospective study of a descriptive type carried out from January 1, 2017 to December 31, 2018. A consent form was filled out and signed by spouses after an interview and a systematically carried out pre-operative clinical and para-clinical assessment. Results: During the study period, 56 tubal ligations were performed i.e. 4.72 percent of all family planning methods. The recruiting for the surgical contraception involved clients whose typical profile is that of women with an average age of 35, mostly housewives (35.71%), major multiparous (69.63%) with 6 living children on average. Married women made up the bulk of the recruiting i.e. 96.44%. Unmarried women made much more use of other methods. Indications of personal convenience were the most frequently encountered common reason. Among medical causes, high blood pres
Many Sub-Saharan African (SSA) countries, like Benin, have scaled up public investment during the last decade. Such a strategy contributed to the improvement of infrastructure, but also to a build-up of debt vulnerabilities. Looking forward, the planned fiscal consolidation will result in some restraint of public spending, and, in particular, public investment. In this context, maintaining or even raising the region's economic growth will require an offset by the private sector. The analysis draws lessons from countries that have successfully transitioned from public investment to private investment-led growth using a global sample starting in the mid-1980s. These lessons highlight policies that have been crucial in fostering a rebound of private investment in the wake of a contraction of public investment. The analytical framework proposed by Hausman, Rodrik and Velasco ( 2005) is used to identify and classify such policies. Finally, the paper analyses how the identified policies could help Benin achieving a smooth transition from public to private sector-led growth.
Aims: To explore stakeholder perceptions on the health of women after female genital fistula repair in Guinea. Methods: In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with stakeholders involved in fistula prevention and management in Conakry, Labé and Kissidougou regions, where EngenderHealth supports fistula repair hospitals. Results: 41 IDIs and seven FGDs (with 42 participants) were conducted with various stakeholders. Women who underwent fistula surgery and were discharged with a closed fistula were described as carrying several health risks. These women are seen as people more exposed to maternal and neonatal complications during pregnancy and childbirth than women who do not experience fistula. The core category that emerged to describe women treated for fistula was “vulnerability”. Women treated for fistula were described as “vulnerable” as compared to “normal” women who have never experienced fistula. The concept of “vulnerability” included physical, social (including mental) and economic dimensions. Physical vulnerability included the sequalae of the condition and the risk of maternal and neonatal complications such as fistula recurrence, abortion or stillbirth. Social vulnerability that includes mental vulnerability was described through the continuous stigmatization of women, the social pressure to fulfil marital duties i.e. resuming sexual intercourse or becoming pregnant again. Economic vulnerability included poverty related characteristics, lack of autonomy that maintain financial barriers to access health care. Conclusions: Fistula care should go beyond surgery by developing and implementing interventions that address women’s physical, psychosocial and economic vulnerabilities.
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