Facteurs associés au recours tardif à la première consultation prénatale dans le district sanitaire de Gao, Mali / Factors associated with late antenatal care in health district in Gao, Mali

Les soins prénatalssont le service fourni aux femmes enceintes afin d'assurer les meilleures conditions de santé pour les femmes et les fœtus pendant la grossesse.Pour être efficace, la consultation prénatale(CPN)doit débuter à un stade précoce de la grossesse; l'organisation mondiale de la santérecommande quatre visites prénatales, la première visite devant avoir lieu avant le troisième mois de la grossesse. L'objectifétaitd'étudier les facteurs associésau recours tardifsà la première consultationprénatale. Cette étude de cas témoin appariéea porté sur des femmes enceintes en consultation prénatale. Au total 447 femmes ont été sélectionnées (cas = 149 témoins = 298). Les logiciels épi info version 7.2.2.6 et SPSS version 25 ont été utilisés pour respectivement saisir et analyser les données.Le model de régression logistique binaire a été utilisé pour estimer les Odds Ratios.La profession(femme au foyer)ORa = 7 [1,20-46,43], le moyen de déplacement ORa = 3,16 [1,11-9,03]etl'assurance maladie ORa = 6,32 [1,30-30,65] étaient significativementassociés au recours tardif à la première consultation. En plus, celle qui n'avaitpasplanifié sa grossesse ORa= 11,16 [5,49-22,68], et celle qui neconnaissait pasla période de début de CPN ORa = 5,36[2,07-13,85]étaient susceptiblesde débuter tardivement leur première consultation.La mise en place des interventions adaptées telle que l'assurance maladie, l'autonomisation des femmes et la sensibilisation pourraient améliorerlafréquentation des services de CPN de façon précoce.

Prenatal care is the service provided to pregnant women to ensure the best health conditions for women and fetuses during pregnancy. To be effective, antenatal care (ANC) must begin early in pregnancy;the first visit occurring before the third month of pregnancy. The objective was to study the factors associated with late attendance at the first prenatal visit. This matched case-control study included pregnant women seen at antenatal clinics. A total of447 women were selected (cases = 149 controls = 298). Epi Info version 7.2.2.6 and SPSS version 25 were used to enter and analyze the data, respectively. The binary logistic regression model was used to estimate the Odds Ratios. Results: Occupation (housewife) ORa = 7 [1.20-46.43], means of travel ORa = 3.16 [1.11-9.03] and health insurance ORa = 6.32 [1.30-30.65] were significantly associated with late first antenatal care. In addition, those who had not planned their pregnancy ORa= 11.16 [5.49-22.68], and those who did not know the timing of ANC ORa= 5.36 [2.07-13.85] were likely to start their first visit late. The implementation of appropriate interventions such as health insurance, women's empowerment and awareness raising could improve early ANC service attendance.

Information about COVID-19: Lessons learned from Mali

Introduction. In Mali, information related to COVID-19 is regularly shared by the coordination board against COVID-19 through daily official press releases and situation reports. The goal of this study was to analyze data related to the tested samples; and the confirmed, contacts, recovered and dead cases in order to take lessons for the future. Population and methods. Data from the first 100 days after the detection of the first cases in Mali were collected and recorded on an Excel file before they got analyzed using SPSS 25.0 software. Analyses were descriptive and correlational. Results. We included 14938 tested samples, 2260 confirmed cases, 12864 contact cases, 1502 recovered cases and 117 deaths were reported during the first 100 days of the epidemic. There was a positive correlation between the number of confirmed cases; and the number of tested samples, the number of recovered cases and the number of deaths. These results suggest that the number of confirmed cases increase with the number of tested samples. Conclusion. These results call for more testing and encourage the identification, location and follow-up of COVID-19 cases. They can also be used to support the improvement of data quality and the response to COVID-19. As a result, they can contribute to improve population health