ABSTRACT
BACKGROUND: In 2015, the Army Teaching Hospital-University Teaching Hospital (HIA-CHU [Hôpital D'instruction des Armées de Cotonou Centre Hospitalier et Universitaire]) laboratory in Benin launched a quality improvement programme in alignment with the World Health Organization Regional Office for Africa's Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA). Among the sub-Saharan African laboratories that have used SLIPTA, few have been francophone countries, and fewer have belonged to a military health system. The purpose of this article was to outline the strategy, implementation, outcomes and military-specific challenges of the HIA-CHU laboratory quality improvement programme from 2015 to 2018. INTERVENTION: The strategy for the quality improvement programme included: external baseline SLIPTA evaluation, creation of work plan based on SLIPTA results, execution of improvement projects guided by work plan, assurance of accountability via regular meetings, training of personnel to improve personnel competencies, development of external stakeholder relationships for sustainability and external follow-up post-SLIPTA evaluation. LESSONS LEARNT: Over a period of 3 years, the HIA-CHU laboratory improved its SLIPTA score by 29% through a quality improvement process guided by work plan implementation, quality management system documentation, introduction of new proficiency testing and internal quality control programmes, and enhancement of personnel competencies in technical and quality management through training. RECOMMENDATIONS: The programme has yielded achievements, but consistent improvement efforts are necessary to address programme challenges and ensure continual increases in SLIPTA scores. Despite successes, military-specific challenges such as the high mobility of personnel have hindered programme progress. The authors recommend that further implementation research data be shared from programmes using SLIPTA in under-represented settings such as military health systems.
ABSTRACT
PURPOSE: The situation of road crashes-related deaths remains problematic in low-income countries. The present study aims at analyzing the first-aid knowledge and practices of professional motorcyclists (PMs) in the city of Cotonou in Benin. MATERIALS AND METHODS: This is a cross-sectional analytical study conducted from 25 March to 19 April 2019 in Cotonou and concerned PMs registered in a fleet who gave their consent to participate in the study. The World Health Organization's two-stage adaptive cluster sampling technique was applied to select the eligible PMs while respecting the proportionality rate per fleet. A logistic regression analysis was done and the odds ratios were estimated with 95% confidence interval. RESULTS: The 430 PMs surveyed were all middle-aged men with an average age of 38.38 (±8.70). Among them, 62.56% knew at least one of the emergency phone numbers for the ambulance, police or fire services and 49.53% of the PMs knew at least one of the 3 techniques evaluated. In addition, 33.23% of PMs who had witnessed at least an RC stated that they had alerted the emergency services, and 32.27% said they had helped the victims. The main reason given for the lack of initiative in RCs was lack of knowledge of the course of action to take (19.64%). The level of knowledge was associated with the level of education (AOR: 3.11; CI 95%: 1.79-5.43) and with the length of experience (AOR: 2.56; CI 95%: 1.58-4.18). CONCLUSION: This study reveals that the level of knowledge and practice of PMs in the field of first aid in Cotonou is low and demonstrates the relevance and the need to include this target group in the first-aid chain for road crashes in Benin.
ABSTRACT
Introduction : L'anémie est un problème de santé publique. Pour une prise en charge efficace, une démarche diagnostique méthodique et rigoureuse doit être observée. Objectif : Evaluer l'évolution de la performance théorique et pratique des médecins en matière de diagnostic des anémies entre 2011 et 2016. Méthodologie : Dans la continuité d'une étude réalisée en 2011, 133 médecins ont été évalué sur leurs performances théoriques et pratiques à mener la démarche diagnostique des anémies. Les con-naissances théoriques ont été évaluées par un questionnaire. La performance pratique a été évaluée à l'aide de 60 dossiers de patients traités pour une anémie non drépanocytaire dans les formationssanitaires retenues. Les différents scores obtenus ont été comparés à ceux de 2011. Résultats : L'analyse globale des résultats montre que 48,1% des médecins enquêtés ont eu une performance insuffisante contre 87,9% en 2011 ; une performance acceptable de 50,4% contre 12,1% en 2011 pour la démarche diagnostique théorique. En ce qui concerne la performance diagnostique pratique, 53,3% des médecins avaient une performance insuffisante contre 74% en 2011 et une per-formance acceptable de 46,7% contre 26% en 2011. Les scores enregistrés en 2016 sont meilleurs à ceux retrouvés en 2011 (p=0,000%) Conclusion : Outre le renforcement de l'enseignement des anémies durant les formations médicales,une politique de formation continue est nécessaire pour remédier aux insuffisances constatées
