Building the Capacity of Health Professionals in Monitoring and Evaluation in a Public Health Institution: Experience of the National Institute of Public Health (NIPH) of Côte d’Ivoire

Background: In the context of the fight against HIV, a lack of skills in monitoring and evaluating the personnel in charge of activities has been identified at the national level. It was the subject of a priority axis of the national plan for monitoring and evaluating the fight against HIV (2006-2010) that was aimed at strengthening the capacities of actors in this area. To increase the critical mass of competent human resources in the short term, the National Institute of Public Health (NIPH) of Côte d’Ivoire organized monitoring and evaluation training sessions for healthcare professionals from 2011 to 2016. Methods: A single case study with multiple levels of analysis was carried out, combining a qualitative survey and a literature review. An evaluation was carried out six months after each training session. In addition, the results of the pre- and post-tests and of the daily and final evaluations that accompanied the various training sessions were used to provide further information. The qualitative data collected were analyzed using INVIVO 15 software. Results: Some 89 health professionals (69% men and 31% women) working at the national level (51% at the central level, including 58% in health programs) and in development partner agencies (37%) participated in this capacity building program. Most participants were senior health managers (56%), data managers (23%), and statisticians and computer scientists (10%). Almost all the trainings were financed by 16 technical and financial partners (85%), mainly the MEASURE Evaluation project (27%). Conclusion: M&E training, despite all its imperfections, has made it possible to identify M&E training needs at the national level and to increase the critical mass of national skills and to have some culture in M&E.

Prevalence of Work-Aggravated Asthma among Bakery Workers in Abidjan (Cote d’Ivoire)

Introduction: Work-aggravated asthma is pre-existing or concomitant asthma whose symptoms are aggravated by the work environment. The aim of this study was to determine the prevalence of this pathology and its associated factors among bakery workers in Abidjan. Materials and Methods: This descriptive and analytical cross-sectional study was conducted over a period of four (4) months from 18 December 2019 to 18 April 2020. Two questionnaires were used, one on employees and the other on the indoor environment of bakeries. In addition, a spirometry test was performed on all bakery workers. Statistical analysis was performed using stata 15.1 software. Results: A total of 599 bakery employees, including bakers (59.73%), sales assistants/ cashiers (23.52%), cleaners (6.34%) and administrative staff (10.18%), were investigated. The mean age was 30.8 ± 8 years, with a sex ratio (M/F) = 2.2. Asthma symptoms were found in 95 (15.86%) employees, of whom 74 (77.9%) had work-related asthma and 11 (14.9%) had asthma aggravated by work. The factors associated with work-aggravated asthma were personal or family history of allergy or atopy [ORa = 3.75;CI95%: 1.56 - 8.93;p = 0.003], exposure to dust [ORa = 5.01;CI95%: 1.43 - 7.50;p = 0.011] and humidity level (60% - 70%) [ORa = 1.80;CI 95%: 0.99 - 3.28;p = 0.05]. Conclusion: Work-aggravated asthma is a reality in bakeries in Abidjan, with an estimated prevalence of 14.9%. Two of the three factors associated with this condition suggest a link with indoor air pollution. Combating air pollution in these establishments must therefore be a priority for the relevant authorities, in order to provide employees with a working environment that protects their health.

Prevalence of Ventilatory Function Abnormalities in Residents of Attecoube Lagune, Abidjan (Côte d’Ivoire)

Introduction: Studies of abnormal ventilatory function in Côte d’Ivoire have been carried out in the workplace and in schools. The objective of this study was to determine the prevalence of respiratory symptoms and ventilatory function abnormalities in the population of the lagoon district of Attécoubé in Abidjan. Material and Methods: A cross-sectional study was carried out on 170 people in the municipality of Attécoubé Lagune. A questionnaire was used to collect information on sociodemographic, clinical, and environmental characteristics. A basic spirometry and a beta mimetic test were carried out on all the subjects surveyed. Data analysis was done with the stata 15.1 software. Results: The study population was composed of 103 women and 67 men with a sex ratio (M/F) of 0.65. The average age was 35.92 ± 15.28 years. The most frequent respiratory symptoms were chest tightness (29.41%), dyspnea (28.82%), sneezing (22.94%) and cough (22.35%). The prevalence of ventilatory function abnormalities was 43.24% among residents of Attécoubé Lagune and the most frequent abnormality was ventilatory restriction (35.15%) followed by obstruction (4.85%). The risk factor for ventilatory function abnormalities was heavy pollution [OR = 2.66;IC: 1.053 - 6.743;P = 0.038]. Conclusion: Residents of the Attécoubé Lagune district had many respiratory symptoms and a high prevalence of ventilatory function abnormalities. Improving air quality is urgently needed in this municipality.

Explanatory Factors for the Variation in HIV Prevalence between Regions of Côte d’Ivoire: An Ecological Study

Introduction: No study has analyzed the reasons for the difference in HIV prevalence between Ivorian regions ranging from 1.3% in the central-western region to 4.1% in Abidjan among men. Objective: To analyze explanatory factors for the difference in HIV prevalence observed in men in Côte d’Ivoire’s regions. Methodology: Assessment of the relationship between HIV prevalence per region and risk factors explored in the 2012 Côte d’Ivoire Demographic and Health Surveys (DHS). A multivariate analysis was conducted to assess the relationship between HIV prevalence and each variable. Results: The explanatory power of the variation of HIV prevalence between regions was 98%. There was a significant association between HIV prevalence and union (r = −0.38;p = 0.008;95% CI (−0.53 to −0.23)), condom use (r = −0.01;p = 0.19;95% CI (−0.03 to −0.01)), practice of Christian religion (r = −0.1;p = 0.017;95% CI (−0.16 to −0.05)), and schooling (r = −0.01;p = 0.25;95% CI (−0.04 to 0.02)). There was a paradoxical association between HIV prevalence and mean age at first sexual intercourse (r = −0.1;p = 0.017;95% CI (−0.16 to −0.05)) and sexual infections (r = −0.48;p = 0.016;95% CI (−0.75 to −0.22)). Conclusion: The explanatory factors for the difference in HIV prevalence observed in men in the regions of the country were union, condom use, mean age at first sexual intercourse, sexual infection, sexual activity, and multiple sexual partnerships. However, only union and condom use were effective in reducing HIV prevalence by preventing new infections.