IntroductionThere are concerns about the impact of the COVID-19 pandemic on the continuation of essential health services in sub-Saharan Africa. Through the Countdown to 2030 for Women’s, Children’s and Adolescents’ Health country collaborations, analysts from country and global public health institutions and ministries of health assessed the trends in selected services for maternal, newborn and child health, general service utilisation.MethodsMonthly routine health facility data by district for the period 2017–2020 were compiled by 12 country teams and adjusted after extensive quality assessments. Mixed effects linear regressions were used to estimate the size of any change in service utilisation for each month from March to December 2020 and for the whole COVID-19 period in 2020.ResultsThe completeness of reporting of health facilities was high in 2020 (median of 12 countries, 96% national and 91% of districts ≥90%), higher than in the preceding years and extreme outliers were few. The country median reduction in utilisation of nine health services for the whole period March–December 2020 was 3.9% (range: −8.2 to 2.4). The greatest reductions were observed for inpatient admissions (median=−17.0%) and outpatient admissions (median=−7.1%), while antenatal, delivery care and immunisation services generally had smaller reductions (median from −2% to −6%). Eastern African countries had greater reductions than those in West Africa, and rural districts were slightly more affected than urban districts. The greatest drop in services was observed for March–June 2020 for general services, when the response was strongest as measured by a stringency index.ConclusionThe district health facility reports provide a solid basis for trend assessment after extensive data quality assessment and adjustment. Even the modest negative impact on service utilisation observed in most countries will require major efforts, supported by the international partners, to maintain progress towards the SDG health targets by 2030.

Summaryobjective To assess whether implementation of a prevention of mother-to-child HIV transmission (PMTCT) programme in Cô te d'Ivoire improved the quality of antenatal and delivery care services.methods Quality of antenatal and delivery care services was assessed in five urban health facilities before (2002)(2003) and after (2005) the implementation of a PMTCT programme through review of facility data; observation of antenatal consultations (n = 606 before; n = 591 after) and deliveries (n = 229 before; n = 231 after) and exit interviews of women; and interviews of health facility staff.results HIV testing was never proposed at baseline and was proposed to 63% of women at the first ANC visit after PMTCT implementation. The overall testing rate was 42% and 83% of tested HIVinfected pregnant women received nevirapine. In addition, inter-personal communication and confidentiality significantly improved in all health facilities. In the maternity ward, quality of obstetrical care at admission, delivery and post-partum care globally improved in all facilities after the implementation of the programme although some indicators remained poor, such as filling in the partograph directly during labour. Episiotomy rates among primiparous women dropped from 64% to 25% (P < 0.001) after PMTCT implementation. Global scores for quality of antenatal and delivery care significantly improved in all facilities after the implementation of the programme.conclusions Introducing comprehensive PMTCT services can improve the quality of antenatal and delivery care in general.keywords maternal health services, quality of care, human immunodeficiency virus, prevention, mother-to-child transmission

Different countries in sub-Saharan Africa face similar nutrition and health issues and are currently not sharing best practices, nutrition programs, and scientific studies optimally. There is a need for closer collaboration among scientists within and between countries.

As a re-emerging disease, beriberi caused by a lack of thiamine in food threatens more and more prisons in developing countries. Indeed in 2008, a beriberi epidemic occurred in a detention house of Côte-d'Ivoire called Maca. The goal of our retrospective investigation was to describe this epidemic in order to improve prisoners' health. The study related to 131 subjects, 64% of cases affected (N = 205). The total rate of beriberi attack was estimated at 38.6‰. The mean age was 33; all patients were male and they were detained in "Batiment C" (70.2%), synonymous with heavy punishment. They spent about 28.1 month in Maca. The clinical symptoms were neurological signs (swarming: 41%) and cardiovascular signs (dyspnoea: 42%, thoracic pain: 35%). Half of the patients (51%) presented oedemas of the lower limbs. The rate of healing was about 97% when patients followed treatment. Providing good nutrition to the prisoners and the distribution of vitamin complements will avoid other epidemics.

Maternal mortality constitutes a major public health problem in Côte d'Ivoire. Better management of pregnant patients and improved quality of pre-natal consultations could contribute to solving this problem. But what is the current situation of these a pre-natal consultations in the medical district of Grand-Bassam? To answer to this question, a descriptive cross-sectional study was carried out between August 26th and September 30th, 2002 in three medical establishments in charge of pre-natal consultations in that District. It was noted that the privacy and the confidentiality during the examination were respected; yet on the other hand, the structures were sometimes unsuited and were insufficiently equipped. The health care professionals were not very accessible or friendly, and they had poor interpersonal communication skill. Recommendations were made to remedy these insufficiencies.