ObjectiveThe purpose and objective of our research is to identify the determinants of the out of pocket (OOP) health expenditures in the population of Ivory Coast and the ratios across three different area; Abidjan, the rural and urban area. We used data from the 2015 standard households living survey conducted by the National Institute of Statistic.ResultsAbout 6315 (13.3%) of the participants had experienced OOP health expenditure. There was significant differences in the self-reported OOP between these three areas (p < 0.001). The overall mean of OOP expenditure among all participants was 16,034.33 XOF (29 USD). People in Abidjan spent an average of 1.6 and 1.5 times more than those in the rural and urban areas respectively (p < 0.001). Hospitalization is the highest expenditure item in terms of money spent, while drugs are the most common item of expenditure in terms of frequency, regardless of the place of residence. Female gender, high social economic status and large household size increase OOP health expenditure significantly in all areas of residence when insurance reduce it. To reduce the impact of the direct payments there is a need to take into account social demographic factors in addition to economic factor in health policy development.Electronic supplementary materialThe online version of this article (10.1186/s13104-019-4048-z) contains supplementary material, which is available to authorized users.

An immunization coverage survey was conducted among children aged 12-59 months in a suburban neighbourhood in Abidjan. The objective was to determine the complete immunization coverage, the reasons for non-vaccination and factors influencing the immunization status of children. The method of exhaustive sampling enabled us to interview the mothers of 669 children using a questionnaire. Overall vaccination coverage was 68.6% with 1.2%, with 1.2% of children never having received vaccine. The logistic regression analysis showed that the level of education, knowledge of the immunization schedule and the marital status of mothers, as well as the type of habitat, were associated with full immunization of children. These determinants must be taken into account to improve vaccination coverage.

West Africa (WA) in recent past experienced decreasing rainfall and increasing temperature. A preliminary assessment of these trends in the future (2025-2045) was conducted to evaluate its potential impact on water resources, specifically the Tono irrigation dam in Ghana. The climate change assessment was based on future climate data of Representative Concentration Pathways (RCPs) 4.5 and 8.5 projected with ECHAM6 model and downscaled by the Weather Research and Forecasting (WRF) model in reference with historical data . A 2-domain configuration was used: an outer domain at 25 km horizontal resolution encompassing the West African Region and an inner domain at 5 km horizontal resolution centered on the Tono basin. The assessment was done based on the annual mean, relative percentage change and spatial seasonal change of the simulated precipitation and temperature. The results show that for precipitation, both scenarios do not agree on the signal of change. RCP4.5 indicates an increase (+7%) in annual precipitation amount whereas RCP 8.5 indicates a decrease (-9.6%). For temperature, both scenarios agree on increasing temperature. These results shows that future streamflow will be influenced by climate change. The indications are that the flows will reduce does the dam levels will also reduce does affecting irrigation activities. This studies therefore provides information to the managers of Tono irrigation dam what measures to put in place for its sustainability.

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Introduction : Le renoncement aux soins pour raisons financières est un indicateur de l’accessibilité économique aux soins. Objectif : L’objectif de ce travail était d’identifier les déterminants du renoncement aux soins pour raisons financières chez les femmes en zone périurbaine à Abidjan. Méthode : Il s’agit d’une étude transversale, réalisée de mars à mai 2019, auprès des femmes de 18 ans et plus dans le quartier d’Anonkoi-3, au nord de la ville d’Abidjan. Les caractéristiques sociodémographiques, économiques, celles de l’état de santé et du renoncement aux soins ont été renseignées à partir d’un questionnaire. Les associations entre le renoncement aux soins pour raisons financières et chacune des caractéristiques étudiées ont été mesurées au moyen de modèles de régression logistiques au risque 5 %. Résultats : Les 423 femmes enquêtées avaient un âge médian de 28 ± 11 ans. Seules 30 % d’entre elles bénéficiaient d’une couverture maladie. Le taux de renoncement aux soins était de 59,1 %. Ce renoncement était plus marqué à l’achat de médicaments, pour les examens biologiques, les soins dentaires et les actes chirurgicaux. Le nombre de personnes à charge ( p  = 0,035), le jeune âge ( p  ≤ 0,035), le faible niveau d’instruction ( p  = 0,024), le faible niveau de revenus ( p  ≤ 0,004), l’absence de vie associative ( p  = 0,004) et la perception d’un mauvais état de santé ( p  = 0,021) ont été identifiés comme déterminants du renoncement aux soins pour raisons financières. Conclusion : L’autonomisation, l’alphabétisation, l’instruction sanitaire des femmes et l’adhésion à la couverture maladie universelle devraient contribuer à lever l’obstacle financier de l’accès aux soins des femmes.