[Community participation for a latrine project in Senegalese rural area]. / Participation communautaire dans un projet de latrines en zone rurale sénégalaise.

The rural community of Ngohé faces serious hygiene and sanitation problems because of the poor quality of water, and in particular due to the lack of latrines in shelters. As of 2003, a three-year project for the construction of latrines was initiated within the framework of a donor agency programme to support the health region of Diourbel. After three years of activity, the poor results recorded provided considerable justification for the analysis of community participation in the project. A cross-cutting descriptive and analytical survey was carried out from December 14 -17th, 2005. Two trained investigators collected the data through individual and group interviews. It was found that there was close community participation in the decision-making process to determine which activities would be undertaken; however, it was limited in the areas of need assessment, mobilization and management of resources as well as monitoring and evaluation. Community participation was considered average concerning the implementation of activities. The low rate of latrines (1.7%), correlated with the high proportion of diarrhea as one of the main reason for consultation in 2004 (33.4%) and 2005 (29.4%), expressed the non-achievement of the project's objectives, which was planned to end in 2006. Many projects have shortcomings and pitfalls in their participatory strategy at al phases, especially during that of implementation. Frequently, participation efforts are limited to the recruitment of community participants. The organization and coordination that should accompany and support strategies for community participation must be adapted to the context of the poor and disadvantaged populations, a majority of whom are illiterate, as they are less sensitized to the benefits of hygiene and health promotion. It is the responsibility of health professionals to organize community representatives and to strengthen their capabilities in the field of hygiene and health in order to ensure the community ownership and sustainability of such projects.

[Factors related to failure to complete immunization of children aged 10-23 months in Ndoulo (Senegal)]. / Facteurs d'abandon de la vaccination des enfants âgés de 10 à 23 mois à Ndoulo (Sénégal).

INTRODUCTION: Avoidable diseases cause more than two million deaths worldwide every year. In sub-Saharan Africa, only half of all children receive their complete vaccine series. In Senegal, an expanded program of immunization began as a pilot program in 1979 and was generalised in 1985. Nonetheless poor population adherence to child immunization makes it difficult to meet its annual target of 80% per vaccine. This study sought to explore the factors related to failure to complete routine immunization in Ndoulo, in the health district of Diourbel. METHOD: A cross-sectional descriptive and analytical survey was conducted from 16-25 April 2005 among mothers of 562 children aged 10 to 23 months in Ndoulo. RESULTS: Among children who started their vaccine series (with BCG vaccine against tuberculosis), 68.0% received the measles vaccine (the last of the series), 67.1% completed the vaccine series (receiving all required vaccines) but only 19.4% were correctly vaccinated according to the program's vaccination schedule, with the correct number of boosters at the appropriate time. Non-compliance with the immunization schedule was related to parents' lack of time (40.3%), forgetting to return (33.2%), losing the immunization card (10.3%), travels (7.7%), and lack of money (1.1%). Completely vaccinated children were more likely to be male, to have their immunization card available, to have parents aware of the vaccines' side effects and the immunization schedule, and to have their immunization paid for by their father. DISCUSSION: In Ndoulo, health district of Diourbel, adequate immunization coverage is very low because of the high rate of abandonment and poor compliance with vaccination schedules. The predominant factors, especially related to the populations, are negligence. CONCLUSION: Actions such as increasing parental awareness, promoting child sponsorship systems, and requiring immunization records for school enrollment, are needed to address these factors, to improve immunization coverage in Diourbel.