Development of Monitoring and Evaluation Systems in Four National Programs Addressing Mother and Child Health in Cote d'Ivoire: Qualitative Analysis of the Emergence and Formulation Process.

Background: Monitoring and evaluation were introduced into the management of national health programs to ensure that results were attained, and that donors' funds were used transparently. This study aims to describe the process of the emergence and formulation of monitoring and evaluation (M&E) systems in national programs addressing maternal and child health in Cote d'Ivoire. Methods: We conducted a multilevel case study combining a qualitative investigation and a literature review. This study took place in the city of Abidjan, where in-depth interviews were conducted with twenty-four (24) former officials who served at the central level of the health system and with six (06) employees from the technical and financial partners' agencies. A total of 31 interviews were conducted from January 10 to April 20, 2020. Data analysis was conducted according to the Kingdon conceptual framework modified by Lemieux and adapted by Ridde. Results: The introduction of M&E in national health programs was due to the will of the technical and financial partners and the political and technical decision-makers at the central level of the national health system, who were concerned with accountability and convincing results in these programs. However, its formulation through a top-down approach was sketchy and lacked content to guide its implementation and future evaluation in the absence of national expertise in M&E. Conclusion: The emergence of M&E systems in national health programs was originally endogenous and exogenous but strongly recommended by donors. Its formulation in the context of limited national expertise was marked by the absence of standards and guidelines that could codify the development of robust M&E systems.

[A description of the yaws infection and prevention conditions in the health district of Adzopé]. / Description de la situation du plan dans ie district sanitaire d'Adzopé : cas des localités d'Asseudji.

This article reports on a cross-sectional study which aims to describe the situation of yaws in the boroughs of Asseudji located in the health district of Adzopé. The study's population group consisted of 206 household heads, and 2182 subjects who were tested and examined for yaws. The primary sources of pollution levels for a household were domestic animal waste (100%) and garbage stored in close proximity to the household's dwelling (49%). Signs of over-crowding were found in 43.7% of households. The sore "mother yaw" is the most common manifestation of yaws (81.5%). However, the majority of household heads were ignorant of the supporting causes and risk factors (64.1%) and the contagious natures of the infection (52.9%). Among the 2182 subjects examined, 11 (5%) had contracted yaws. The proportion of households with at least one case of yaws was 3.4%. The results of this census demonstrate that swift and strong action should be taken in these towns to prevent the outbreak of an epidemic.