Assessing Community Health Interventions in Reducing Infant and Child Mortality in the Southeastern Benin

Background: To reduce infant and child mortality in Benin, a package of high-impact interventions per healthcare level was implemented in 2009. This study aimed to assess the quality of community-based health interventions in reducing infant and child mortality within the municipality of Pobè in southeastern Benin. Methods: This was a cross-sectional evaluative study carried out in November 2021 focused on children aged 0 - 59 months, their mothers, health workers, community facilitators, community health workers and the Town Hall health focal point. Mothers and their children were targeted by cluster sampling, and exhaustive selection was used to recruit all other participants. Predetermined scores based on rating criteria were used to assess the quality of community health interventions using the “input, process and outcome” of Donabedian approach. Results: Over 300 mother-child couples, 46 community health workers, 7 health agents, 1 community facilitator and 1 health focal point from Pobè town hall were surveyed. Intervention quality was judged as “average”, with a score of 73.80%. The “inputs” and “outcomes” components were the weakest links. Conclusion: Improving access to the inputs needed by community health workers can enhance the quality of PIHI interventions.

Socio-Medical and Demographic Factors Associated with Perinatal Mortality in a Southern Benin Health Zone Hospital in 2020: A Case-Control Study

Background: Perinatal mortality remains a major public health concern in developing countries such as Benin. To better steer response interventions, this study was carried out in southern Benin with the aim of identifying the demographic and socio-medical factors linked to perinatal mortality. Methods: The case-control study, held from January 1 to December 31, 2020, covered 154 targets, including 77 cases of neonates deceased within the perinatal period and 77 live-born control neonates selected on a one-for-one basis. Univariate analysis using the McNemar test and logistic regression were used to identify risk factors for perinatal mortality, at a 5% threshold of significance. Results: Sahoué/mina ethnicities, only associated socio-demographic characteristic, increased the risk of perinatal death by 2.47 times (p = 0.008). Mother’s age, education, occupation, marital status, and household size were not associated (p > 0.05). Risk of death was increased 2.5 times when the mother was referred (p = 0.007), 3.3 times when she came from a hard-to-reach locality (p Conclusion: Although attention must also be paid to referral and access to care, this study identifies antenatal consultation as the main target of any intervention to reduce perinatal mortality.

Religion and “Zero-Dose” Vaccination Status in Children Aged 12 to 23 Months in Benin and Togo: “Evidence of Demographic and Health Survey and Multiple Indicator Cluster Surveys”

Introduction: The relationship between religion and health has been a topic of interest in the past, and in recent years it has become increasingly visible in the social, behavioural, and health sciences. This work aims to study the influence of religion on the “zero-dose” vaccination status of children aged 12 - 23 months in Benin and Togo. Methods: This was a cross-sectional study which consisted in carrying out secondary analyzes using the databases of the most recent editions of the Demographic and Health Surveys in Benin and the Multiple Indicator Cluster Surveys (MICS) in Togo. We extracted data concerning the vaccination status (“1 = zero-dose”, “0 = vaccinated”) of the children, the religious affiliation of the head of the household or the mother and other variables related to the child, the mother, the household and the environment. By means of a logistic regression, the adjusted effect of the religious affiliation of the head of the household or of the mother on the vaccination status at “zero-dose” was determined. Results: A total of 2430 and 933 children were respectively included in the study on behalf of Benin and Togo. The prevalence of “zero-dose” vaccination status in children aged 12 - 23 months was 33.91% (95% CI = 31.67 - 36.23) in Benin and this prevalence was 26.88% (95% CI = 23.50 - 30.55) in Togo. In Benin, there is no evidence in favour of the influence of the religious affiliation of the mother on the “zero-dose” vaccination status of children. In Togo, children living in households whose head was Muslim (ORa = 3.44;95% CI = 1.29 - 9.13) were more likely to be “zero-dose” than those coming from households run by individuals with no religious beliefs. Conclusion: Further research is needed to understand the basis for the excess risk of “zero-dose” vaccination status in children that appears to be associated with the Muslim religion.

Dietary Vitamin K Restriction and Effectiveness of Vitamin K Antagonists Prescribed at the CNHU-HKM University Cardiology Clinic/BENIN

Introduction: Their efficacy in preventing thrombotic and embolic events has been proven in numerous studies, but their narrow therapeutic index requires particular vigilance, especially in terms of biology. In addition, treatment-related hemorrhagic complications are not uncommon. This study explores the influence of dietary vitamin K restriction on the efficacy of antivitamin K treatment at the University Cardiology Clinic of CNHU-HKM. Methods: Cross-sectional and descriptive study that took place from 25 April to 29 August 2019. Patients’ dietary behaviors and successive INR values were collected. Information on dietary intake was obtained by 2 non-consecutive 24-hour recalls. The effectiveness of VKA treatment was assessed by the “Time in Therapeutic Range” (TTR) of the INR. VKA treatment was considered effective for a TTR greater than 65%. Results: At the end of this study, 40 patients were surveyed. The mean age of the participants was 58.05 years ± 13.32 years, with a sex ratio of 1.35. Complete arrhythmia due to atrial fibrillation was the main indication for VKA treatment (37.50%) and fluindione was the most commonly prescribed drug (77.50%). The duration of treatment was less than or equal to 2 years in 47.5% of the subjects surveyed. Before starting treatment, 85% of patients received advice on restricting vitamin K-rich foods, and 45% of patients reported “food burnout” after a period of compliance with the restriction. The majority of respondents (97.50%) complied with the restriction on vitamin K-rich foods. All respondents had high energy intakes and a poor distribution of macronutrients, with a predominance of carbohydrates and proteins. 2.5% of respondents were on effective anti-vitamin K therapy with a TTR of over 65%. Conclusion: Restriction of vitamin K-rich foods is not conducive to effective treatment with vitamin K antagonists.

Factors Associated with Diet Quality in Women of Childbearing Age in Southern Benin in 2022

Background: The nutritional status of women while in pregnancy influences foetus growth, infant development, and the mother’s health. The objective of this study was to assess diet quality and associated factors among women of childbearing age in the Comè community, Benin. Methods: The cross-sectional and analytical study involved 215 participants randomly selected by multi-stage sampling technique. Two non-consecutive dietary recall data were collected as well as sociodemographic information. The International Food Quality Index (IQD-I) was used to assess diet quality. Factors associated with the nutritional quality of the diet were identified by using linear regression. Results: Among 212 women, a diet quality of 175 (82.55%) was fair while 14.62% had good diet quality. Factors associated with the diet quality were the level of household possession, health issues, and nutritional advice at the health care facilities. Conclusion: Nutritional education interventions and income-generating activities may improve the diet quality among women of childbearing age in the Comè in Benin.