Effect of living conditions on genital mutilation practices among adolescent girls in West Africa: A pooled analysis from demographic and health surveys.

Despite commitments and interventions, Female Genital Mutilations (FGM) practice persists in West African countries. This research analyzes the effect of living conditions on FGM practice. Data were sourced from thirty-four demographic and health surveys conducted between 1995 and 2020 in 12 countries. The study sample consisted of 69,971 adolescent girls aged 15-19 years. Meta-regression analysis and binary logistic regression analyses showed the effect and relative contribution of study covariates on the phenomenon. The overall average prevalence of FGM is 40.7%, with a mixed effect of living conditions on FGM practice. The factors associated with FGM practice are, in order of importance, religion, level of education, ethnicity and place of residence. All factors have a direct effect on the studied phenomenon, and the level of education acts as an inhibiter of the effect of living conditions. The study suggests the need to strengthen the involvement of religious, traditional and community leaders in the definition and implementation of actions to combat FGM, as well as girl's education, especially by maintaining them in school till completion of at least secondary school.

Acceptability of coupling intermittent preventive treatment in infants with the expanded programme on immunization in three francophone countries in Africa.

OBJECTIVE: Intermittent preventive treatment in infants (IPTi) is a malaria control strategy currently recommended by WHO for implementation at scale in Africa, consisting of administration of sulphadoxine-pyrimethamine (SP) coupled with routine immunizations offered to children under 1 year. In this study, we analysed IPTi acceptability by communities and health staff. METHODS: Direct observation, in-depth interviews (IDIs) and focus group discussions (FGDs) were conducted in Benin, Madagascar and Senegal during IPTi pilot implementation. Villages were stratified by immunization coverage. Data were transcribed and analysed using NVivo7 software. RESULTS: Communities' knowledge of malaria aetiology and diagnosis was good, although generally villagers did not seek treatment at health centres as their first choice. Perceptions and attitudes towards IPTi were very positive among communities and health workers. A misconception that SP was an antipyretic that prevents post-vaccinal fever contributed to IPTi's acceptability. No refusals or negative rumours related to IPTi coupling with immunizations were identified, and IPTi did not negatively influence attitudes towards other malaria control strategies. Healthcare decisions about children, normatively made by the father, are starting to shift to educated and financially independent mothers. DISCUSSION: Intermittent preventive treatment in infants is well accepted by providers and communities, showing a synergic acceptability when coupled with routine immunizations. However, a misconception that SP alleviates fever should be addressed when scaling up implementation.