Establishing Surgical Care Sustainability in Sub-Saharan Africa for Global Child Health: Insights From Pediatric Cardiac Surgical Capacity-Building Programs in Ethiopia and Côte d'Ivoire

The global surgery research team of the JW LEE Center for Global Medicine, Seoul National University College of Medicine, introduced team-based health workforce training programs for pediatric cardiac surgery in Ethiopia and Côte d'Ivoire. A team-based collaborative capacity-building model was implemented in both countries, and details of the program design and delivery were documented. The research team shared their experiences and identified achievements, lessons, and challenges for cardiac surgical interventions in Sub-Saharan Africa. Future directions were put forward to advance and strengthen the low-and middle-income countries “Safe Surgery.”

Apports des images Landsat à la dynamique de l’occupation du sol et à l'analyse des conflits d’usage dans le département de Dianra au nord de la Côte d’Ivoire

Localisé dans la zone d’extension pastorale au nord de la Côte d’Ivoire, le département de Dianra subit une recomposition des formes spatiales qui structurent son territoire. L’enjeu majeur de l’analyse des mutations socio-écologiques dans ce contexte est l’identification des différents types de conflits d’usage liés à la dynamique de l’occupation du sol obtenue à partir des techniques de la télédétection. L’étude s’est effectuée d’une part sur la base de l’analyse d’images satellite Landsat à 3 dates différentes 1986, 2001 et 2016 et d’autre part sur la mobilisation de données collectées à partir de la recherche bibliographique et d’enquêtes de terrain dans le cadre d’une approche visant à comprendre l’évolution des règles, des normes et des comportements liés à l’usage des ressources naturelles. Les données recueillies ont permis de séquencer cette évolution en deux périodes : la période de 1986 à 2001 qui est caractérisée par une abondance des ressources ligneuses : 70 % de savane (savane arbustive et savane arborée) en 1986 et 16 % de forêt dense sèche et de forêt-galerie. Cette phase est marquée par une gestion communautaire des ressources naturelles. Tandis que la deuxième période de 2001 à 2016 est caractérisée par la diminution des ressources ligneuses : 37 % de savane (savane arbustive et savane arborée) et 2 % de forêt dense sèche et de forêt- galerie. La dynamique de l’occupation du sol conduit au rétrécissement des pâtures naturelles et au morcellement de l’espace. Cela engendre des conflits d’usage, de plus en plus récurrents entre agriculteurs d’anacarde et éleveurs qui ont des visions antagonistes de l’usage de l’espace et des conflits hégémoniques entre des villages pour le contrôle des espaces.

What Influences Rice Farmers’ Choices of Credit Sources in Côte d’Ivoire? An Econometric Analysis using the Multinomial Conditional Logit Model

In Côte d’Ivoire, the low participation of smallholder farmers in the credit market remains a matter of concern. This study examines the key determinants of rice farmers’ participation in the credit market. We use a Multinomial Conditional Logit model to consider the characteristics related to the use of different credit sources. A total of 588 rice farmers were randomly sampled from seven rice areas. Our findings reveal that gender, age, education level, experience in rice farming, rice plot size, lowland rice farming, extension contact, membership of a farmer-based organization, marketing of paddy rice, and off-farm income significantly influence the use of different credit sources. While credit requirements such as saving plus collateral, kinship/friendship, membership, favoured client, loan maturity, and the distance between borrowers and lenders are credit source-specific variables that significantly determine rice farmers’ choices between different credit sources. These empirical results show that in addition to farmer-specific variables, policymakers should consider the characteristics of credit sources for developing a credit market suitable for smallholder farmers.

Is it possible to recruit HIV self-test users for an anonymous phone-based survey using passive recruitment without financial incentives? Lessons learned from a pilot study in Côte d’Ivoire

Background Due to the discreet and private nature of HIV self-testing (HIVST), it is particularly challenging to monitor and assess the impacts of this testing strategy. To overcome this challenge, we conducted a study in Côte d’Ivoire to characterize the profile of end users of HIVST kits distributed through the ATLAS project (AutoTest VIH, Libre d’Accéder à la connaissance de son Statut). Feasibility was assessed using a pilot phone-based survey. Methods The ATLAS project aims to distribute 221300 HIVST kits in Côte d’Ivoire from 2019 to 2021 through both primary (e.g., direct distribution to primary users) and secondary distribution (e.g., for partner testing). The pilot survey used a passive recruitment strategy—whereby participants voluntarily called a toll-free survey phone number—to enrol participants. The survey was promoted through a sticker on the HIVST instruction leaflet and hotline invitations and informal promotion by HIVST kit-dispensing agents. Importantly, participation was not financially incentivized, even though surveys focussed on key populations usually use incentives in this context. Results After a 7-month period in which 25,000 HIVST kits were distributed, only 42 questionnaires were completed. Nevertheless, the survey collected data from users receiving HIVST kits via both primary and secondary distribution (69% and 31%, respectively). Conclusion This paper provides guidance on how to improve the design of future surveys of this type. It discusses the need to financial incentivize participation, to reorganize the questionnaire, the importance of better informing and training stakeholders involved in the distribution of HIVST, and the use of flyers to increase the enrolment of users reached through secondary distribution.