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Assessing the Impact of Health Insurance on Household Financial Protection in Togo

Health 2023年第6期15卷 507-516页

作者： Aboubakar Issa yaovi tossou Kodjo Evlo Département d’Politique et Système de Santé Institut Régional de Santé Publique Ouidah Bénin Programme Couverture Sanitaire Universelle Ministère de la Santé de l’Hygiène Publique et de l’Accès Universel Aux Soins Lomé Togo Direction des études de la Planification et de la Programmation Ministère de la Santé de l’Hygiène Publique et de l’Accès Universel Aux Soins Lomé Togo Département d’Economie Faculté des Sciences économiques et de Gestion Université de Lomé Lomé Togo

Context: To facilitate financial access to care for the population, health insurance mechanisms have been established, in particular the National Health Insurance Institute, which covers civil servants and their dependents. In addition, other voluntary and community mechanisms have been developed. After several years of implementation, the level of catastrophic health expenditures among insured individuals shows that there is still a considerable level of financial risk associated with health care. This study aims to assess the impact of health insurance in Togo on insured populations. Methodology: The data used in this study come from the harmonized survey on household living conditions carried out in 2018 by the National Institute of Statistics, Economic and Demographic Studies. The propensity score matching method was used according to the following steps: estimation of propensity scores, verification of the conditional independence hypothesis (balancing property) and estimation of the average treatment effect on treated. Stata V14.2 software was used. Findings: The average effect of health insurance on household financial protection is −0.012 for the nearest neighbor method, −0.013 for the matching radius method, −0.015 for the Kernel and −0.016 for the stratification method. Results showed that health insurance contributes to reducing catastrophic health expenditures, but their effect remains very limited. This could be explained by the level of care package covered and the cost covered. Conclusion: Health insurance contributes to the reduction of catastrophic health expenses for households. However, it is important to widen the range of care covered and the cost covered. In addition, measures to extend this coverage to a larger proportion of the population will make it possible to have a greater impact.

关键词： Impact Health Insurance Catastrophic Expenditure

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Effect of Supplementary Irrigation on the Yield of Sorghum (Sorghum bicolor L. Moench) in the Context of Climate Change in the Dry Savannahs of Togo

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American Journal of Climate Change 2024年第2期13卷 163-174页

作者： Adjiwanou Atiglo-Gbenou yaovi Ouézou Azouma Jean Mianikpo Sogbedji Agricultural Mechanization and Process Engineering Research Team (ERMAP) Department of Rural Engineering and Agricultural Machinery School of Agronomy University of Lom Lom Togo Soil Climate ad Crop Sciences Interface Laboratory (LISSCPV) Department of Soil Science School of Agronomy University of Lom Lom Togo

Under the current context of climate change, supplementary irrigation may be needed for crop production resilience. We determined the effects of supplementary irrigation on sorghum grain yield in the dry Savannah region of Togo. A two-year trial was conducted in a controlled environment at AREJ, an agro-ecological center in Cinkassé. The plant material was sorghum variety Sorvato 28. The experimental design was a Completely Randomized Block with three replications and three treatments as follows: T0 control plot (rainfed conditions);T1 (supplementary irrigation from flowering to grain filling stage) and T2 (supplementary irrigation from planting to grain filling stage). Two irrigation techniques (furrow and Californian system) were used under each watering treatment. The results showed that irrigation technique significantly affected panicle length with no effect on 1000 grains mass. Panicle length and grain yields varied from 15.59 to 25.71 cm and 0.0 to 2.06 t∙h−1, respectively, with the highest values (25.66 cm and 2.06 t∙h−1, respectively) under the T2 treatment with the California system-based supplementary irrigation. The comparison of results obtained on treatment T0 and T2, shows that supplementary irrigation increased the yields by at least 68.62%. Supplementary irrigation during sowing and growing season (T2) improved sorghum yields in the dry savannahs of Togo, with a better performance of the California irrigation system.

关键词： Climate Change Supplementary Irrigation Sorghum Grain Yield Dry Savannah Togo

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Multi-Model Approach for Assessing the Influence of Calibration Criteria on the Water Balance in Ouémé Basin

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Journal of Water Resource and Protection 2024年第3期16卷 207-218页

作者： Aymar yaovi Bossa Mahutin Aristide Oluwatobi Kpossou Jean Hounkpè Félicien Djigbo Badou National Institute of Water University of Abomey-Calavi Cotonou Benin Ecole d’Horticulture et d’Aménagement Des Espaces Verts Université Nationale d’Agriculture Kétou Benin

Hydrological models are very useful tools for evaluating water resources, and the hydroclimatic hazards associated with the water cycle. However, their calibration and validation require the use of performance criteria which choice is not straightforward. This paper aims to evaluate the influence of the performance criteria on water balance components and water extremes using two global rainfall-runoff models (HBV and GR4J) over the Ouémé watershed at the Bonou and Savè outlets. Three (3) Efficacy criteria (Nash, coefficient of determination, and KGE) were considered for calibration and validation. The results show that the Nash criterion provides a good assessment of the simulation of the different parts of the hydrograph. KGE is better for simulating peak flows and water balance elements than other efficiency criteria. This study could serve as a basis for the choice of performance criteria in hydrological modelling.

关键词： Hydrological Modelling Performance Criteria Water Balance Ouémé Basin

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Flood Risk Assessment in the Lower Valley of Ouémé, Benin

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Open Journal of Modern Hydrology 2024年第2期14卷 130-151页

作者： yaovi Aymar Bossa Octave Djangni Yacouba Yira Jean Hounkpè Angèle D. Avossè Luc Ollivier Sintondji National Institute of Water University of Abomey-Calavi Abomey Calavi Benin Africa Centre of Excellence for Water and Sanitation University of Abomey-Calavi Abomey Calavi Benin Hydro-Climate Services Ouagadougou Burkina Faso Applied Science and Technology Research Institute-IRSAT/CNRST Ouagadougou Burkina Faso

In response to the increased frequency of flood events in recent years, it has become crucial to enhance preparedness and anticipation through precise flood risk assessments. To this end, this study aims to produce updated and precise flood risk maps for the Lower Valley of Ouémé River Basin, located in the South of Benin. The methodology used consisted of a combination of geographical information systems (GIS) and multi-criteria analysis, including Analytical Hierarchy Process (AHP) methods to define and quantify criteria for flood risk assessment. Seven hydro-geomorphological indicators (elevation, rainfall, slope, distance from rivers, flow accumulation, soil type, and drainage density), four socio-economic vulnerability indicators (female population density, literacy rate, poverty index, and road network density), and two exposure indicators (population density and land use) were integrated to generate risk maps. The results indicate that approximately 21.5% of the Lower Valley is under high and very high flood risk, mainly in the south between Dangbo, So-Ava, and Aguégués. The study findings align with the historical flood pattern in the region, which confirms the suitability of the used method. The novelty of this work lies in its comprehensive approach, the incorporation of AHP for weighting factors, and the use of remote sensing data, GIS technology, and spatial analysis techniques which adds precision to the mapping process. This work advances the scientific understanding of flood risk assessment and offers practical insights and solutions for flood-prone regions. The detailed flood risk indicator maps obtained stand out from previous studies and provide valuable information for effective flood risk management and mitigation efforts in the Lower Valley of Ouémé.

关键词： Flood Hazard Exposure Vulnerability Risk Lower Valley of Ouémé

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Associated Factors to Poor Blood Pressure Control in Hypertensives Followed Up at the Campus University Hospital of Lome (Togo)

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World Journal of Cardiovascular Diseases 2024年第6期14卷 374-380页

作者： Soulemane Pessinaba yaovi Mignazonzon Afassinou Wiyao Dieudonné Kaziga Komlavi Yayehd Kolani Lamboni Sélim Bolarinwa Mohamed Kpélafia Ekpe Togbossi Akpe Adzodo Machihude Pio Soodougoua Baragou Findibé Damorou Cardiology Department University Hospital of Campus Lome Togo Cardiology Department Sylvanus Olympio University Hospital Lome Togo Cardiology Department Kara University Hospital Kara Togo

Introduction: Hypertension is a real public health issue and its control is very difficult. We aim to determine the frequency of uncontrolled hypertension in hypertensive patients followed up as an outpatient at the campus university hospital of Lome (Togo) and to search for the associated factors. Methodology: The study was cross-sectional, descriptive and analytical, carried out from February (2022) to August 2022 in 260 hypertensive patients aged 22 years old, followed up (on an) as an outpatient for at least 3 months at the Lome University Hospital campus. A univariate then multivariate analysis were conducted in order to highlight the most common factors significantly linked to uncontrolled. Results: The mean age of hypertensives was 56.4 ± 12.7 years, the sex ratio (M/F) was 0.59. Prevalence of uncontrolled blood pressure was 42%. Associated Factors to poor blood pressure control in our study were age > 60 years (OR = 1.6 CI [1.17 - 2.50]), low socio-economic level (OR = 2.2 CI [1.96 - 4.33]), high cardiovascular risk level (OR = 3.1 CI [2.18 - 4.52]), non-adherence to regular blood pressure monitoring (OR = 3.3 CI [2.21 - 5.55]), low compliance to treatment (OR = 4.1 CI [2.33 - 6.76]) and a chronic renal failure (OR = 2.1 CI [1.21 - 3.10]). Conclusion: Nearly half of the hypertensives in our study had poorly controlled blood pressure by antihypertensive treatment medication. The factors of this poor control were age > 60 years, low socio-economic level, high or very high level of cardiovascular risk, low compliance to treatment, and renal failure.

关键词： Hypertension Poor Control Associated factors Togo

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C1C2 Wiring and Posttraumatic Atlantoaxial Dislocation: An Effective and Cheap Surgical Procedure in a Developing Country

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Surgical Science 2024年第5期15卷 357-370页

作者： Ibrahim Dao Massimiliano Visocchi Salah Sow John Jabang Ousmane Ouattara Astride Somda Abdoulaye Sanou Elie Dibloni Nassoum Arsène tossou Narcisse Ouedraogo Frédéric Bako Massadiami Soulama Malick Diallo Patrick Wendpouiré Hamed Dakouré Department of Neurosurgery University Hospital Souro Sanou Nazi Boni University Bobo Dioulasso Burkina Faso High Institute of Health Sciences Nazi Boni University Bobo Dioulasso Burkina Faso Military Hospital Colonel Major Tanguet Ouattara Bobo Dioulasso Burkina Faso Institute of Neurosurgery Craniovertebral Junction Surgery Unit School of Medicine Catholic University Rome Italy Department of Radiology and Medical Imaging University Hospital Yalgado Ouedraogo Joseph Ki-Zerbo University Ouagadougou Burkina Faso Department of Neurosurgery (Unit) Edward Francis Small Teaching Hospital Banjul Gambia Department of Neurosurgery University Hospital Yalgado Ouedraogo Joseph Ki-Zerbo University Ouagadougou Burkina Faso Department of Neurosurgery Military Hospital Capitaine Halassane Coulibaly Ouagadougou Burkina Faso Department of Orthopedic Surgery University Hospital Souro Sanou Nazi Boni University Bobo Dioulasso Burkina Faso

Objectives: Atlantoaxial dislocation remains a rare and serious condition with a high preoperative and postoperative morbidity and mortality. Its successful surgical management is still challenging and gratifying for neurosurgeons. Several technics have been described such as wiring, trans articular screwing, C1C2 screwing with plate and screw introduced by Goel et al., and modified by insertion of polyaxially screw and rod many years later by Harms. Unavailability and expensiveness of upper cervical spine instrumentation device led us to C1C2 Wiring resulting in a good outcome. Finally, a quadriplegic patient with a more comfortable financial condition had ordered devices from abroad and benefit for Goel and Harms screwing technique and improved dramatically from ASIA A to ASIA E. Material and methods: This is a retrospective study of patients managed in our department by a same neurosurgeon from January 2019 to April 2024. Results: We defined 6 men and 1 woman with an average age of 33 years. Unrestrained driver in a rollover motor vehicle accident was most common. Only one patient was neurologically intact on admission. Neurovegetative disorders were noticed in one patient. Dislocation was associated to a fracture of the dens in two patients. Three patients have been successfully operated with remarkable outcome, mostly from ASIA A to E. Conclusion: C1C2 dislocation is a serious condition and C1C2 Wiring represents an effective and cheaper technic. Therefore, this technic should deserve consideration above all in low incomes countries when screwing devices are not available. Seatbelt should be demanded for motor vehicle drivers and passengers.

关键词： Superior Cervical Spine Dislocation Fracture Wiring Screwing Neurovegetative Disorders

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Extension of Chemoprevention of Seasonal Malaria to Five Cycles and to Children from the Age of 6 to 9 Years in Africa: Analysis of Its Acceptability, Feasibility, Cost and Impact A Systematic Review

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Advances in Infectious Diseases 2024年第1期14卷 74-86页

作者： N’Kpingou Théodore Nadakou Moussiliou Noel Paraïso Ounoussa Tapha Mahamane Moustapha Lamine Jean Blaise Yobo Salifou Ibrahim Alkassoum Fidel tossou Hamidou Ramatoulaye Lazoumar Eric Omar Adehossi Regional Instutte of Public Health University of Abomey-Calavi (UAC) Ouidah Benin Pratical Institute of Public Health (IPSP) Niamey Niger Andre Salifou University of Zinder (UAS) Zinder Niger ABDOU Moumouni University of Niamey (UAM) Niamey Niger Medical and Health Researche Center (CERMES) Niamey Niger

Introduction: Seasonal Malaria Chemoprevention (SMC) aims at preventing malaria in children during the high transmission season. It has been recommended by the WHO since 2013 for children from the age of 3-59 months. However, despite the impact of this intervention, a peak in the prevalence and incidence of malaria is observed in children from the age of 5-9 years. The aim of this study is to determine from the current literature the feasibility, impact and cost-effectiveness of extending SMC to five cycles and to older children. Methods: A litterature search of PubMed/Medline, NCBI and Google scholar identified 1333 articles. After reading the titles and abstracts by two authors, 24 articles were selected and submitted for full reading. Random control studies on the extension of SMC, malaria, feasibility of SMC, impact of SMC and cost-effectiveness of SMC were selected. A total of 16 articles were included for the qualitative synthesis after excluding 8 studies. Results: Following the summary of the evidence, we conclude that the extension is feasible but will be confronted with the unavailability of older children. The intervention period coincides with field work. SMC is effective in reducing the prevalence and incidence of malaria and the parasite density in children. The financial cost of administering SMC is lower than that of treating a child suffering from malaria. Conclusion: After analysing the information, it was found that the majority of the African population supports the extension of the SMC to the number of cycles and the age group in order to alleviate the high mortality and morbidity rates among children due to malaria.

关键词： SMC Feasibility Impact Profitability and Africa

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Understanding Farmers’ Perceptions of and Adaptations to Climate Change and Variability: The Case of the Maritime, Plateau and Savannah Regions of Togo

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Agricultural Sciences 2015年第12期6卷 1441-1454页

作者： Agossou Gadédjisso-tossou West African Science Service Center on Climate Change and Adapted Land Use (WASCAL) Université de Lomé Lomé Togo

Togolese agriculture is predominantly rain-fed and hence fundamentally dependent on the vagaries of weather. Thus, it is negatively affected by climate change. The present study assesses farmers’ perceptions and adaptation to climate change to enhance policy towards tackling the challenges climate change poses to the farmers in the study area. Descriptive statistics and multinomial logit (MNL) were used to analyze data obtained from a cross-sectional survey executed during the 2013/2014 agricultural production year in the maritime, plateau and savannah regions of Togo. The analysis of farmers’ perception to climate change reveals high increase in temperature and decrease in rainfall. These results are in line with the trend analysis of climate data that records from 1961 to 2013 about the study area especially on the temperature. Furthermore, the results show that crop diversification, change in crops, find off-farm jobs, change of the amount of land, change of the planting date and plant short season variety are the adaptation methods employed by the farmers. Moreover, with respect to the multinomial logit analysis, the results highlight that education level, farming experience, access extension services, access to credit and access to climate information are the factors that enhance farmers’ adaptive capacity to climate change and variability. Thus, there is room for better adaptation if government intensifies activities of extension workers and ensures that farmers have access to affordable credit schemes to increase their ability and flexibility to adopt adaptation measures. There is also a need to include climate change communication to facilitate exchange of climatic information that could enable smallholder farmers to adapt to changing planting dates. Finally, investment in education systems and creation of off-farm job opportunities in the rural areas can be underlined as a good policy option.

关键词： Climate Change Agriculture Perception Adaptation Multinomial Logit

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Mother-to-Child Transmission of HIV/AIDS during Pregnancy and Delivery and Associated Factors in the Region of Couffo in Benin

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World Journal of AIDS 2020年第2期10卷 128-140页

作者： Jean yaovi Daho Badirou Aguemon Pascal Hinnakou Faculty of Health (FSS/UAC) Community Health and Epidemiology Unit Cotonou Benin Information Center Testing Care and Research in Mono Department Benin

Evaluation of the effectiveness of the mother-to-child HIV Prevention Program, in Benin in 2016 reported a national rate of 6.7%. The Region of Couffo, within 12 Regions (departments) in the country, had the highest rate of transmission, which was 16.1%. The study aimed to determine transmission rate during pregnancy and delivery as well as the factors associated with it. This is a retrospective and analytical study based on a sample of seventy (70) babies born to HIV-infected mothers in 2016 in Couffo. Key findings showed, there is a perinatal transmission of five percent (5%) and the factors associated with this transmission are: delay in carrying out first antenatal visits at the health facility, low frequency of visits performed versus number requested and appropriate time, poor health condition of mothers during pregnancy, absence or late start of antiretroviral care and treatment during pregnancy, irregular intake of intermittent presumptive treatment at sulfadoxine-pyrimethamine to prevent malaria, a short antiretroviral therapy (less than three months) for mothers before delivery and the default in cleaning mother’s genital tract with betadine after the woman’s water broke.

关键词： HIV (Human Immunodeficiency Virus) Mother-to-Child Transmission Pregnancy Childbirth

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Impact of Nitrogen Fertilization on the Oil, Protein, Starch, and Ethanol Yield of Corn （Zea mays L,） Grown for Biofuel Production

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Journal of Life Sciences 2011年第12期5卷 1013-1021页

作者： Roland Ahouelete yaovi Holou Valentin Kindomihou University of Missouri Delta Research Center P.O. Box 160 Portageville MO 63873 USA Monsanto Company 80ON. Lindbergh Blvd. Mail Zone Q4B/Q420E-A St. Louis MO 63167 USA Laboratory of Applied Ecology Fac. of Agronomic Sci. University of Abomey-Calavi Cotonou O1 BP 526 Benin

Nitrogen fertilization is one of the greatest challenges associated with the production of biofuel from corn grain. The objective of this research was to determine the effect of N fertilization on the content and yield of oil, protein, and starch in corn grain. The project was done in Southeast Missouri （USA）, from 2007 to 2009 in a silt loam soil. Corn grain contains 3.8-4.2% oil, 6.7%-8.9% protein, 68.0%-70.4% extractable starch, and 76.0%-77.7% total starch. The total starch yield ranged from 2.8 to 7.8 ***1 whereas the extractable starch varied between 2.5 to 7.1 mg-ha1. As the N rate went up, the oil and starch content of the grain decreased, whereas the protein content and the protein, starch, and oil yields increased, reaching their maximum at the N rate corresponding to 179.0 kg ***~. The potential ethanol yield varied between 616.2 and 7,035.1 L-ha1 depending on the method of conversion of the starch into ethanol, the year and the N rate （P 〈 0.0001）. The negative correlation between N fertilization rate and starch content suggested that when farmers add too much N to their soil to increase grain yield, they reduce the starch content in those grains, and consequently the conversion into bioethanol. Therefore, for biofuel production to be beneficial for both farmers and the power plant owners, an agreement needs to be made with regard to the use of fertilizers.

关键词： Starch oil protein corn kernel biofuel ethanol nitrogen

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