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Accès et recours aux soins de santé dans les structures sanitaires de Yopougon-Sicogi (Abidjan-Côte d’Ivoire)

Abstract : Yopougon-Sicogi is a neighborhood of the commune of Yopougon, situated in the district of Abidjan in Côte d’Ivoire. It is a planned and well built commune that has a strong human concentration. It also has several health structures distributed over small areas that offer a variety of health care services However, despite the proximity of populations with these health care institutions (100% of the population are within 2 km of these health facilities) and their multitude of health care services, the attendance rate for all these health facilities (8.89% in 2010, 10.41% in 2013, 9.28% in 2014) never exceeded the recommended WHO standard of 50% attendance. Confronting with this situation, the main problem here is to know the socio-spatial factors that influence the access and the recourse of the populations to the sanitary structures of Côte d’Ivoire. Thus, the objective of this study is to analyse the different socio-spatial factors that influence the access and the recourse of the populations to the sanitary structures of Yopougon-Sicogi. This geographical micro spaces study was done on a sample of 181 households and 269 customers and determined from the fisher test on the basis of a stratified opinion poll. Qualitative and quantitative data were collected through interviews with health authorities and health infrastructure promoters, and also through two types of questionnaires: one for households and the other for clients (patients). Descriptive, spatial, bivariate and multivariate analyzes were done. The Chi-2 independence test and the Cramer test were performed. The logistic regression model was also constructed. All identified the socio-spatial factors on which access and use of Yopougon-Sicogi health facilities depend. Also the spatial distribution model of these health facilities across the neighborhood space and the reasons justifying their low attendance were identified. The results show that, the seven existing sanitary structures in Yopougon-Sicogi are exclusively turned toward the private health care services. There unequalled distribution in this area has been influenced by the proximity of the general hospital, the markets, the rarity of sanitary structures in the neighborhood, the lack of public health care and the bad aspects of road infrastructures in the district. In addition, the sanitary structures are note of good quality in comparison with those in the central districts. The obtained diagram is specific to Yopougon-Sicogi and the availability of the private health care. The triangular scheme obtained remains specific to the neighborhood and to the private health care offer. Besides, the results show the variables: sex, age, size of the household, profession, income, level of study, cost of health care and type of service have been very important on the utilization of these health infrastructures (chi-2 cal > chi-2 tab). However, the value of Cramer's V showed that the variables strongly related to the use of these health structures are the age and the cost of care (V = 5.2 and v = 6.4). The study showed that 89% of the households do not frequent these sanitary structures. The reasons of their low interest is linked to the unsuitability between apply and demand, the lack of trust in the medical staff as well as their proximity with the general hospital. However, to reduce all forms of sanitary inequalities in Côte d’Ivoire, this study recommends a collaboration between specialists of health and social studies.
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Submitted on : Friday, August 20, 2021 - 10:55:37 AM
Last modification on : Saturday, August 21, 2021 - 2:46:09 PM

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Bi Sehi Antoine Tape. Accès et recours aux soins de santé dans les structures sanitaires de Yopougon-Sicogi (Abidjan-Côte d’Ivoire). Géographie. Université Félix Houphouet Boigny (Côte d'Ivoire), 2017. Français. ⟨tel-03323035⟩

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