BackgroundOne of the control tools to reduce malaria transmission is the use of LLINs. However, several studies show that household bed net use is quite low. A study was developed to better understand the cultural factors that might explain these gaps in Benin. One reason mentioned is that bed nets can catch on fire and cause harm. This paper presents a summary of these findings, their analysis and the ensuing issues.MethodsThis anthropological study is based on an inductive qualitative approach, including 91 semi-structured interviews conducted from July 2011 to March 2012 in a health district in Southern Benin.ResultsFifty-six persons stated that bed nets can catch on fire but do not always refer to specific facts. However, 34 of the 56 people narrate specific events they heard or experienced. 39 accounts were geographically located and situated in time, with various details. In 27 situations, people were burned, for which 12 people reportedly died.DiscussionThe disparity between these results and the dearth of bibliographic documentation in the initial search prompted a more in-depth literature review: 16 contributions between 1994 and 2013 were found. Bed net fires were noted in 10 countries, but it is impossible to ascertain the frequency of such events. Moreover, bodily harm can be significant, and several cases of death attributed to bed net fires were noted.ConclusionsIndisputably, the use of bed nets to reduce the impact of this terrible disease is an optimal control method. However, the perception that LLINs have a potentially negative effect hinders the use rate in the real world, at least for some. If some people fear the risk of fires, this possibility must be addressed during information and prevention sessions on malaria, with a communication strategy tailored to specific social contexts. Moreover, all possible measures should be taken to limit the harm suffered by individuals and their families.

IntroductionThis article aims at investigating social engagement in the fight against the COVID-19 pandemic in low-resource settings (LRSs). In particular, it focuses on Benin (Sub-Saharan Africa), and reports the results of a field study that investigated the local people's acceptance of the vaccine and the tracking program.MethodsThis project is the product of a collaboration between the ABSPIE (Applied Biomedical and Signal Processing E-Health) Lab of the University of Warwick (UK) and the LAMA (Laboratoire d'Antropologie Medical Appliqué) of the University of Abomey Calavi (Benin). This international multidisciplinary collaboration brought together engineers, sociologists, anthropologists, and bioethicists. In light of the aims of the project, a qualitative methodology was deemed appropriate. The research team prepared two questionnaires that provided the basis for semi-structured interviews that took place between June and August 2021.ResultsThe research team interviewed 34 Beninese respondents, comprising people aged 60+ (with multiple comorbidities), who were primarily healthcare workers and/or traditional therapists. The results of this work highlight the fact that there is widespread reticence about the vaccination program in Benin, both due to local beliefs and uncertainty about governmental management. In this study, we uncovered several local reasons interfering with the involvement of the population in the vaccination campaign against COVID-19, e.g., the existence of traditional medical practices considered as valid alternatives to vaccines, and many beliefs showing a fear of neo-colonialism hidden in the pandemic threat. Yet, another hindrance can be traced to shortcomings in the management of the vaccination campaign which resulted in obstacles to the implementation of the program.ConclusionsThis work does not intend to denounce any governmental effort or foster a regressive mindset, but shows how the overall confusion (defined by the World Health Organization as infodemic) linked to the pandemic and its management has caused even more dramatic consequences in LRSs. In addition, the paper proposes a specific framework for the interpretation and management of bioethical and biomedical issues in LRSs that the authors are validating in their current research.

Background: Hand Hygiene (HH) is widely recognized to be one of the most successful and cost-effective measures for reducing the incidence of healthcare-associated infections (HAIs). The hand hygiene behavior of hospital healthcare workers (HCWs) is not well-documented in Benin. Therefore, Theoretical Domains Framework (TDF) was used to identify the behavioral determinants that may impact HCWs’ hand-hygiene compliance in a public hospital. Methods: A qualitative design comprising face-to-face semi-structured interviews with nine HCWs. The interviews included questions on transmission of infections, hand-hygiene practices, problems with their implementation; and ways to improve hand hygiene compliance. Two pharmacists independently coded interviews into behavioral domains using the TDF and then subdivided them into several themes. Interview transcripts were analyzed following 3-steps approach: coding, generation of specific beliefs, and identification of relevant domains. Results: Almost all interviewees have cited the environmental context and resources (such as lack of water) as a barrier to HH practice. They also believed that role models had a significant impact on the good practices of others HCWs. Fortunately ,they were confident of their capabilities to perform appropriate HH behaviors. The majority (7/9) reported having the necessary knowledge and skills and believed they could carry out appropriate HH behavior. In all cases, the participants were motivated to carry out HH behavior, and it was recognized that HH remains the cornerstone to reduce health care associated infections. Conclusion: This study identified several behavioral constructs aligned with the TDF that can be targeted and help for the development of new hand-hygiene interventions. These may increase the likelihood of a successful intervention, thereby improving HH compliance and patient safety, especially in hospitals.

Referral is generally perceived as necessary in the case of complications during pregnancy, by both referred women and healthcare personnel. However, differences in points of view are observed when the woman is referred to CUGO.

International audienceL’utilité des sciences sociales pour faire face à l’épidémie à virus Ebola ne fait plus débat aujourd’hui. Dans les pays en situation épidémique, des chercheurs en sciences sociales (anthropologues et sociologues) ont été précocement associés à la réponse pour adapter les messages d’information vers la population, favoriser l’acceptation des décisions de santé publique (surveillance communautaire des cas suspects, isolement des cas confirmés, enterrements sécurisés, etc.), pour « humaniser » les pratiques de soins et les pratiques funéraires ; mais aussi pour évaluer les impacts sociaux de l’épidémie. Une expérience de la contribution des sciences sociales a été acquise dans l’action sur le terrain.Dans les pays voisins d’un foyer épidémique, les systèmes de santé tentent de prévenir une flambée épidémique tout en s’y préparant. Ils anticipent l’organisation de la réponse médicale pour prendre en charge les malades et limiter les transmissions en disposant des équipements, en formant le personnel médical, en définissant des espaces de soins, etc. Les connaissances empiriques acquises dans les pays les plus touchés permettent aux autres pays de se préparer mieux et plus vite, en améliorant la stratégie et les procédures. Les sciences sociales doivent être associées à cette préparation des systèmes de santé car désormais les épidémies « se précèdent elles-mêmes », au sens où la diffusion des interprétations et leurs effets sociaux précèdent celle du virus.Une des conséquences de l’accélération et de la globalisation des échanges d’informations est qu’ avant même qu’un cas ne soit avéré dans une région ou un pays, des rumeurs, interprétations conspirationnistes (par exemple : c’est une maladie importée par les Occidentaux, c’est le vaccin qui inocule la maladie, etc.) ou des politiques (interférant avec les messages sanitaires destinés à la population), réactions xénophobes, revendications de fermeture des frontières ou refus des dispositifs de traitement sont déjà en place.De plus, la vulnérabilité des pays à l’épidémie dépend étroitement de déterminants sociaux préexistants qu’il faut comprendre, pour ajuster la réponse, tels que les flux migratoires entre pays et le statut des frontières par rapport aux découpages identitaires, l’acceptabilité du dispositif de prévention et dépistage de la maladie mis en place, les rapports de la population au système de santé, les tensions intercommunautaires, la mémoire d’autres épidémies qui conditionne les attitudes, l’intervention de l’Etat sur un mode répressif ou inclusif vis-à-vis des sociétés civiles, les parti-pris des médias, etc.La propagation de l’épidémie à virus Ebola en Afrique de l’Ouest a révélé la fragilité et les défaillances des systèmes de santé des pays touchés. Au-delà de la réponse immédiate à l’épidémie, la contribution des sciences sociales doit, à présent, se situer dans une perspective d’analyse des causes sociales et politiques, locales et globales, de cette épidémie. Il est également temps d’envisager dès à présent la situation...