Explore the vast range of titles available.

Background Efficiency in the use of financial and other resources for providing adolescent sexual and reproductive health (ASRH) policies and programs is an important factor that can affect provision of and access to services in resource-constrained contexts of developing countries with limited capacity. However, very few studies have been conducted to understand this situation. Our study, therefore, estimated technical efficiency scores for health facilities that offer primary ASRH care services in Niger and the relationship between the capacity of these health facilities and their level of technical efficiency. Methods The data used for this study were collected from a survey of 71 primary healthcare facilities providing ASRH in Niger from January 28 to March 15, 2022. A stochastic frontier analysis technique based on the Cobb-Douglas production function specification was used for analysis. A Tobit model estimation was used to examine the relationship between health facility capacity and the level of technical efficiency. Results The average technical efficiency in production of primary care ASRH services of the health facilities in the sample was 58% implying high levels of technical inefficiency. Disaggregated analysis revealed that the average score was greater in health facilities where the primary caretaker or head of the institution was female (60%) rather than male (53%). Primary healthcare facility capacity was assessed in four dimensions of operational capacity, managerial capacity, adaptive capacity and leadership capacity. There was a positive association between health facility capacity and the technical efficiency score. However, the levels of association differed from one dimension of health facility capacity to another. Conclusions There is much room for improving the efficient use of financial and other resources in primary healthcare facilities that provide ASRH in Niger. Potential interventions include giving women more responsibility for these facilities and strengthening the ASRH production capacity of these facilities.

Primary healthcare (PHC) facilities have become essential in promoting adolescent healthcare, yet they face resource limitations that hinder their effectiveness. Ensuring the efficient use of available resources has therefore become pertinent. This study assessed the technical efficiency of primary health care facilities in providing adolescent mental sexual and reproductive health (AMSRH) services. Data was collected from 53 PHC facilities drawn from rural and urban locations in four districts in the Greater Accra region using a multi-stage sampling design. Stochastic Frontier Analysis (SFA) was employed to estimate the technical efficiency of each facility in optimizing outputs given available inputs. The findings revealed significant variation in efficiency, ranging from 0.91 to 0.04 with an average score of 0.60. Rural facilities and government-owned health facilities were more efficient compared to their urban and private counterparts. Facilities offering a wider scope of services to adolescents were also more efficient. However, the provision of adolescent mental health services was limited. Efforts should improve efficiency in the use of AMSRH services by properly aligning resource allocation to needs while expanding the range of services available to adolescents.

Background Adolescent mental health (AMH) is a critical issue worldwide, particularly in West Africa, where it is intensified by socio-economic, cultural, and security challenges. Insecurity and the presence of mining sites expose adolescents to hazardous environments, substance abuse, and adulterated alcohol, further aggravating their mental health. Despite these severe issues, research on AMH in this region remains limited. This study aims to analyze the provision of AMH services in Burkina Faso, Ghana, and Niger, highlighting the unique challenges these countries face within the broader West African healthcare context. Methods The study adopted a multi-stage, stratified sampling design to collect data from primary healthcare centers (PHCs) in the three countries. Using STATA.17, Descriptive analysis was conducted on the data related to availability of AMH services, types of mental health disorders treated, resources available, and OPD attendance rates. The analysis also incorporated factors such as the rural-urban divide and the presence of national guidelines for AMH services. Results The findings reveal a significant shortfall in the provision of AMH services across the region, with less than 30% of PHCs across all the countries offering these services. The study also highlights a pronounced rural-urban disparity in AMH service availability, a general absence of national guidelines for AMH care, and low OPD attendance rates. Conclusion The study highlights the urgent need for comprehensive policy reform and targeted interventions to enhance AMH services in West Africa. Key policy reforms should include the development and implementation of national guidelines for AMH care and integration of AMH services into primary healthcare. Additionally, efforts should focus on capacity building through the training of mental health professionals, increasing public awareness to reduce stigma, and ensuring equitable resource allocation across rural and urban areas. Improving AMH care is essential not only for the well-being of adolescents but also for driving broader socio-economic development in the region.

Adolescent mental health (AMH) is a critical issue worldwide, particularly in West Africa, where it is intensified by socio-economic, cultural, and security challenges. Insecurity and the presence of mining sites expose adolescents to hazardous environments, substance abuse, and adulterated alcohol, further aggravating their mental health. Despite these severe issues, research on AMH in this region remains limited. This study aims to analyze the provision of AMH services in Burkina Faso, Ghana, and Niger, highlighting the unique challenges these countries face within the broader West African healthcare context. The study adopted a multi-stage, stratified sampling design to collect data from primary healthcare centers (PHCs) in the three countries. Using STATA.17, Descriptive analysis was conducted on the data related to availability of AMH services, types of mental health disorders treated, resources available, and OPD attendance rates. The analysis also incorporated factors such as the rural-urban divide and the presence of national guidelines for AMH services. The findings reveal a significant shortfall in the provision of AMH services across the region, with less than 30% of PHCs across all the countries offering these services. The study also highlights a pronounced rural-urban disparity in AMH service availability, a general absence of national guidelines for AMH care, and low OPD attendance rates. The study highlights the urgent need for comprehensive policy reform and targeted interventions to enhance AMH services in West Africa. Key policy reforms should include the development and implementation of national guidelines for AMH care and integration of AMH services into primary healthcare. Additionally, efforts should focus on capacity building through the training of mental health professionals, increasing public awareness to reduce stigma, and ensuring equitable resource allocation across rural and urban areas. Improving AMH care is essential not only for the well-being of adolescents but also for driving broader socio-economic development in the region.

Le vieillissement de la population est un phénomène qui touche la majorité des sociétés occidentales. Ce phénomène se traduit par une croissance du poids relatif, en proportion de la population totale, des personnes âgées de 65 ans et plus, combinée à une décroissance de la proportion des autres groupes d’âge. Cette réalité démographique engendre de nouveaux enjeux sociaux et économiques concernant spécifiquement les aînés tels que l’accès au logement, la précarité financière, l’isolement social et la mise en place de structures adéquates (ex. : soins à domicile) permettant de combler les besoins en assistance et en soins. Des actions publiques sont alors nécessaires afin d’assurer une qualité de vie adéquate à ce groupe d’individus généralement plus vulnérables que l’ensemble de la population. Des données probantes et à jour sont essentielles à la prise de décisions et la mise en place d’actions concrètes. Si ces données existent aux niveaux fédéral et provincial, une carence s’observe au niveau régional. Il s’agit du cas de la région des Laurentides. Dans le but de combler cette insuffisance, ce document présente le portrait sociodémographique et économique des personnes de 65 ans et plus de cette région à partir des données du recensement de Statistique Canada.

Le vieillissement de la population est un phénomène qui touche la majorité des sociétés occidentales. Ce phénomène se traduit par une croissance du poids relatif, en proportion de la population totale, des personnes âgées de 65 ans et plus, combinée à une décroissance de la proportion des autres groupes d’âge. Cette réalité démographique engendre de nouveaux enjeux sociaux et économiques concernant spécifiquement les aînés tels que l’accès au logement, la précarité financière, l’isolement social et la mise en place de structures adéquates (ex. : soins à domicile) permettant de combler les besoins en assistance et en soins. Des actions publiques sont alors nécessaires afin d’assurer une qualité de vie adéquate à ce groupe d’individus généralement plus vulnérables que l’ensemble de la population. Des données probantes et à jour sont essentielles à la prise de décisions et la mise en place d’actions concrètes. Si ces données existent aux niveaux fédéral et provincial, une carence s’observe au niveau régional. Il s’agit du cas de la région de Laval. Dans le but de combler cette insuffisance, ce document présente le portrait sociodémographique et économique des personnes de 65 ans et plus de la région de Laval à partir des données de recensement de Statistique Canada.

Trachoma is the commonest infectious cause of blindness worldwide. Efforts are being made to eliminate trachoma as a public health problem globally. However, as prevalence decreases, it becomes more challenging to precisely predict prevalence. We demonstrate how model-based geostatistics (MBG) can be used as a reliable, efficient, and widely applicable tool to assess the elimination status of trachoma. We analysed trachoma surveillance data from Brazil, Malawi, and Niger. We developed geostatistical Binomial models to predict trachomatous inflammation-follicular (TF) and trachomatous trichiasis (TT) prevalence. We proposed a general framework to incorporate age and gender in the geostatistical models, whilst accounting for residual spatial and non-spatial variation in prevalence through the use of random effects. We also used predictive probabilities generated by the geostatistical models to quantify the likelihood of having achieved the elimination target in each evaluation unit (EU). TF and TT prevalence varied considerably by country, with Brazil showing the lowest prevalence and Niger the highest. Brazil and Malawi are highly likely to have met the elimination criteria for TF in each EU, but, for some EUs, there was high uncertainty in relation to the elimination of TT according to the model alone. In Niger, the predicted prevalence varied significantly across EUs, with the probability of having achieved the elimination target ranging from values close to 0% to 100%, for both TF and TT. We demonstrated the wide applicability of MBG for trachoma programmes, using data from different epidemiological settings. Unlike the standard trachoma prevalence survey approach, MBG provides a more statistically rigorous way of quantifying uncertainty around the achievement of elimination prevalence targets, through the use of spatial correlation. In addition to the analysis of existing survey data, MBG also provides an approach to identify areas in which more sampling effort is needed to improve EU classification. We advocate MBG as the new standard method for analysing trachoma survey outputs.

BackgroundModel-based geostatistics (MBG) is increasingly used for estimating the prevalence of neglected tropical diseases, including trachoma, in low- and middle-income countries. We sought to investigate the impact of spatially referenced covariates to improve spatial predictions for trachomatous inflammation—follicular (TF) prevalence generated by MBG. To this end, we assessed the ability of spatial covariates to explain the spatial variation of TF prevalence and to reduce uncertainty in the assessment of TF elimination for pre-defined evaluation units (EUs).MethodsWe used data from Tropical Data-supported population-based trachoma prevalence surveys conducted in EUs in Ethiopia, Malawi, Niger, and Nigeria between 2016 and 2023. We then compared two models: a model that used only age, a variable required for the standardization of prevalence as used in the routine, standard prevalence estimation, and a model that included spatial covariates in addition to age. For each fitted model, we reported estimates of the parameters that quantify the strength of residual spatial correlation and 95% prediction intervals as the measure of uncertainty.ResultsThe strength of the association between covariates and TF prevalence varied within and across countries. For some EUs, spatially referenced covariates explained most of the spatial variation and thus allowed us to generate predictive inferences for TF prevalence with a substantially reduced uncertainty, compared with models without the spatial covariates. For example, the prediction interval for TF prevalence in the areas with the lowest TF prevalence in Nigeria narrowed substantially, from a width of 2.9 to 0.7. This reduction occurred as the inclusion of spatial covariates significantly decreased the variance of the spatial Gaussian process in the geostatistical model. In other cases, spatial covariates only led to minor gains, with slightly smaller prediction intervals for the EU-level TF prevalence or even a wider prediction interval.ConclusionsAlthough spatially referenced covariates could help reduce prediction uncertainty in some cases, the gain could be very minor, or uncertainty could even increase. When considering the routine, standardized use of MBG methods to support national trachoma programs worldwide, we recommend that spatial covariate use be avoided.