Sexualité et santé de la reproduction

High-risk induced abortion is a public health problem in Burkina Faso, particularly for young women. What explains their vulnerability to high-risk abortion? Is it specific to their age, so that this is a risk factor? Or is it due to their social environment (social norms, laws, etc.)? In-depth repeated interviews with 30 unmarried women between 17 and 31 who had had an abortion are used to define the use of abortion as a sequence of three stages when potential vulnerability may occur. This vulnerability emerges against a background of changes in the social entry into adulthood and diverging social norms, and the three stages are vulnerability to the risk of pregnancy, vulnerability due to being pregnant and vulnerability to high-risk abortion. Any action intended to counter this phenomenon needs to take account of these stages and the features of each one, in particular the central role played by the father of the fetus.

Our paper examines the relationship between genital excision and the sexual behaviour of adolescent girls. The hypothesis we examine is that excised women have a greater libido than the non-excised. Previous studies show that the rate of female genital mutilation in very high in Burkina Faso; the 1998 Demographic and Health Survey noted that nearly 72% of women between 15 and 49 had been excised, and among women of the same age interviewed for the 2006 DHS, nearly 77% stated that they had been excised. Our data come from the 2010 DHS. We use both descriptive methods like variance analysis and multidimensional scaling and explanatory methods, notably the logistic regression model.

Using a descriptive evaluative approach, our study assesses the action taken under the plan to accelerate the reduction in maternal mortality at the Alfarabi regional hospital, referring to the strategic intervention guidelines contained in the Ministry’s 2008-2012 strategy. Data collection was by questionnaire given to the staff of the hospital’s maternity unit, interviews with senior managers for plan implementation, and an observation grid and structured interviews of in-patient mothers in the postnatal departments. The study shows that the implementation of the plan has brought about improvements: drug availability, maternity unit upgrading, staff capacity building in risk-free childbirth, and has also increased the sensitivity of the maternal death surveillance system. The Alfarabi regional hospital’s various indicators have improved: childbirth in a safe care facility rose from 66.30% in 2006 to 91.09% in 2011, and the proportion of caesareans from 4.8% in 2006 to 7.69% in 2011.

The rapid expansion of the city of Ouagadougou, due largely to migration from rural areas, raises a real health problem in general, and a reproductive health one in particular, including that of high-risk pregnancies among under-18 girls. In this study we use data from the Ouagadougou population observatory (OPO) set up in late 2008, for five districts containing a population of approximately 80,000 in 2009, half of whom living in informal housing on the northern outskirts of Ouagadougou. The target population is all the OPO women aged 12-18. A descriptive analysis describes these girls’ demographic, socio-economic and health characteristics according to their migration status. The Cox proportional hazards model is used to identify the explanatory factors of high-risk pregnancies. We conclude that young, poor and uneducated migrant girls are more exposed to high-risk pregnancies than the locally born, and this may be a function of the length of time since they arrived.

The province of Katanga, located in south-eastern Democratic Republic of the Congo and with a surface area of 496,877 km², has 11,462,290 inhabitants, 68% of whom are under the age of 25. One out of every four adolescents between the ages of 15-19 has already given birth to at least one child. The prevalence of HIV is 5.6%, and only 6% of girls and women aged 15 to 24 said they had used a condom during their most recent sexual intercourse with a casual partner (MICS, 2010). The commitment of the local authorities to move the ICPD agenda forward is very strong. UNFPA supports the government’s efforts, which show clear financial commitment, in particular as regards promoting adolescents’ and young people’s access to sexual and reproductive health information, advice and services. The approach adopted is “youth for youth". The strategies used include advocacy, establishing alliances with journalists, rallying young people and adolescents, partnerships, mobilising resources, self-financing, offering VCT and family planning services and attractive services. In 16 months, 250 young people/adolescents used the services at the centre every day; 120,000 were made aware of HIV/AIDS prevention methods and the consequences of early fertility and marriage; 4,000 were screened for HIV thanks to mobile VCT; 20 educator pairs and 14 young journalists were trained; and 15 youth health clubs were created in schools.

Tunisia adopted a family planning policy in the 1960s and was the first Arab or African country to introduce a policy of voluntary reduction of fertility in 1964. At the same time, legislation was adopted to support this population policy. The Code of Personal Status led to the abolition of polygamy, a higher age at marriage, and repudiation was replaced by divorce, equally available to either spouse. After the start of the national family planning programme (1964), the rate of use of contraception by married women of childbearing age continued to rise, from 31% in 1978 to 63% in 2001. In the 2006 MICS3 survey, for the first time, a fall of 3 percentage points in contraceptive prevalence to 60% was observed. This figure alarmed Tunisian policymakers who decided to hold a further survey to verify it in the Greater Tunis region, where a significant fall in the use of contraception had been observed. The results of the supplementary MIC3 survey confirmed those of MICS3. The question for policymakers is, who are the women who contributed to this fall in contraceptive prevalence?

Several international conferences and symposia are witness to the relevance and extent of poverty today. By way of illustration, the ICPD programme of action (International Conference on Population and Development), adopted by consensus in Cairo in September 1994, has highlighted the needs of women and men in terms of reproductive health to achieve both human and social development and fulfilment (WHO, 1996). There was no significant reduction in poverty in Niger between 1992 and 2008, where figures went from 63% to 59.5%, compared with the 2015 target of 31.5% (NIGER, MDG acceleration framework). Poverty leads to poor health but poor health contributes to financial poverty. The health repercussions of poverty can be seen in poor health indicators in general and maternal health in particular. According to the WHO, 99% of all maternal deaths occur in developing countries such as Niger where the percentage of women who consult trained personnel for at least one prenatal visit is 46% (EDSN-MICS III 2006). The general aim of this study is to determine the impact of poverty on access to obstetrical care in Niger.

The illegal nature of abortion forces people into the backstreets, where methods are dangerous and the abortion conditions unsuitable, with many consequences in terms of morbidity mortality among girls. This study examines the practice of abortion in Cameroon and its real causes. It relates the practice of abortion to poverty and the fear of social disapproval, on the basis of statements from adolescents, young people and their parents. Specifically, it seeks to determine the profile of the young people who abort and to understand all the practices associated with abortion. It is based on data from the qualitative survey held as part of the Demtrend project, entitled “Poverty and adolescent and young people’s unmet needs in reproductive health in Central Africa”. Factsheets and portraits are established to help data processing. Thematic content analysis and identification of typologies are used for analysis. The study finally documents the links between abortion, poverty and fear of social disapproval.

For some years now, global health issues have re-emerged among the major concerns on the global agenda, given the continued growth of the global population, particularly in sub-Saharan Africa. Cameroon and Senegal are sub-Saharan African countries involved in this population growth. They have high mother and child mortality rates and low economic growth rates. According to USAID (2009), access to family planning could contribute to reducing this mother and child mortality. In order to promote family planning and publicise the use of contraception, various population policies have been undertaken in the two countries. However, the reduction in fertility is only slight since the population remains pro-natalist in its attitudes. The main aim of this study is to carry out a comparative analysis of the disparities observed in the non-use of modern contraception by women living in a couple in Cameroon and Senegal. It establishes the profiles of women living in a couple who do not use modern contraception and identifies common features of this non-use in Cameroon and Senegal.