Prépublications

Malnutrition is a major public health problem in the Democratic Republic of Congo, with 3.3 million children under five years affected by acute malnutrition. Understanding the socio-demographic determinants of malnutrition is essential for designing effective interventions. This article examines the socio-demographic characteristics of children hospitalized with severe malnutrition in two referral hospitals in the Mongala Province. A descriptive cross-sectional study was conducted in the general referral hospitals of Binga and Bumba in the Mongala Province, including all children under five years hospitalized for malnutrition during 2023 (n=325). Data were collected through documentary analysis of hospital records. Variables analyzed included age, sex, place of residence, parental occupation, religion, dietary habits, and vaccination status. Children aged ≥24 months were more affected at 63.1%. The sex ratio was 1.7 in favor of males. The majority of children resided in rural areas at 68.0%. Most household heads were farmers at 60.6% or unemployed at 39.4%. Complete vaccination coverage was observed in only 52.3% of children, with significant differences between hospitals at 58.5% at Binga versus 41.7% at Bumba. Food consumption was dominated by low-protein local staples: Fuku at 36.9%, Pondu at 33.8%, and Malemba at 29.2%. Differences in dietary patterns were observed between hospitals, with Fuku more consumed at Binga (53.7% versus 8.3% at Bumba) while Malemba was more consumed at Bumba (75.0% versus 2.4% at Binga). Severe malnutrition in hospitalized children in the Mongala Province is associated with specific socio-demographic characteristics including older age (≥24 months), male sex, rural residence, parental farming or…

In the context of global health governance, low- and middle-income countries (LMICs) face significant disparities in implementing public health policies. This comparative qualitative study draws on a structured literature review and thematic analysis to examine the policies and management strategies of health systems in selected countries (Germany, Brazil, Burkina Faso). Using Braun & Clarke’s thematic approach, five key themes emerged: system performance and inequality, effectiveness of preventive policies, innovative management strategies, persistent structural challenges, and contextual comparisons. Results highlight the importance of context-sensitive governance, leveraging digital innovation, community participation, and stronger inter-institutional coordination. The discussion emphasizes the need to move beyond top-down, normative frameworks toward more hybrid, inclusive, and flexible models. These findings suggest the urgency of reshaping health system governance to enhance resilience, equity, and sustainability.

Mental health conditions constitute a growing public health challenge in West Africa, where access to quality mental health services remains limited due to inadequate funding, shortages of trained personnel, weak policy implementation, and the continued concentration of services in urban psychiatric facilities. This study comparatively examines the integration of mental health services into community primary healthcare systems in Burkina Faso and Ghana, with particular attention to the implications for achieving Sustainable Development Goal (SDG) Target 3.4 on mental health and well-being. The study adopts a comparative case study approach based on the analysis of peer-reviewed literature, national policy documents, WHO mental health profiles, and recent empirical studies on adolescent and adult mental health service delivery in both countries. The analysis focuses on four key dimensions: policy and legislative frameworks, human resources and workforce training, service availability and utilization, and mental health financing. Findings indicate that Ghana has made comparatively greater progress through the enactment of the Mental Health Act 2012 (Act 846) and the expansion of community-based mental health initiatives. However, significant implementation gaps continue to undermine service accessibility and quality. In contrast, Burkina Faso experiences more profound structural challenges, including limited policy infrastructure, severe shortages of mental health professionals, inadequate financing, and heavy reliance on traditional and informal care systems. In both countries, less than one-third of primary healthcare facilities provide basic mental health services, while utilization rates among adolescents and adults remain critically low, particularly in rural communities. The study further reveals that legislative reforms alone are insufficient…

Rehabilitation medicine aims to restore function and maximize quality of life for individuals with disabilities or chronic conditions resulting from stroke, spinal cord injury, traumatic brain injury, amputation, and neurodegenerative diseases. Over the past four decades, biomedical engineering has transformed rehabilitation from a primarily therapeutic, labor-intensive discipline into a technology-driven field integrating advanced diagnostics, assistive devices, neuroprosthetics, and data-driven outcome measurement. This article provides a comprehensive review of biomedical engineering contributions across four major domains: (1) neuroprosthetics and brain-computer interfaces for restoring motor and communication function; (2) robotic exoskeletons and powered orthoses for gait rehabilitation and upper extremity assistance; (3) advanced biomaterials and tissue engineering for musculoskeletal repair and neural regeneration; and (4) sensor-based outcome measures and telerehabilitation systems for personalized, remote monitoring. Using a systematic literature synthesis (n=187 peer-reviewed studies, 2010-2025) and comparative analysis of clinical trial data, we quantify functional gains achieved with biomedical engineering interventions relative to conventional therapy. Meta-analytic findings indicate that biomedical engineering-assisted rehabilitation improves upper extremity motor recovery (standardized mean difference SMD=0.72, 95% CI 0.58-0.86), gait velocity (SMD=0.61, 95% CI 0.48-0.74), and activities of daily living independence (SMD=0.54, 95% CI 0.41-0.67) compared to usual care. However, substantial barriers to translation persist, including high device costs (exoskeletons $70,000-$120,000), limited insurance reimbursement, inadequate clinician training, and lack of interoperability among systems. We propose a tiered adoption model stratifying interventions by clinical setting: high-intensity biomedical engineering for acute inpatient neurorehabilitation, mid-tier open-source and low-cost devices for community outpatient settings, and minimalist sensor-based telerehabilitation for home monitoring. The…

Conflict-affected populations face profound health challenges that extend beyond physical injuries to encompass psychological trauma, social disruption, and spiritual suffering. This article examines the concept of Medicine of Peace as a holistic health approach for conflict-affected populations, drawing on the framework developed by the Cercle de Réflexion des Nations. The research analyzes the key components of the Medicine of Peace framework—including the recognition of collective trauma, the integration of diverse medical traditions, the emphasis on psychological healing, the role of compassion and love, and the institutional mechanisms for implementation. The study reveals that Medicine of Peace offers a comprehensive approach that addresses the multiple dimensions of health in conflict settings, recognizing that healing individuals and communities is essential for peacebuilding. The framework challenges the compartmentalization of modern medicine, the neglect of psychological and spiritual dimensions of health, and the separation of health interventions from peacebuilding. The article argues that Medicine of Peace provides a valuable conceptual framework for humanitarian health interventions in conflict settings, offering a more holistic and integrated approach than current models. The findings contribute to the growing literature on health and peacebuilding and offer practical implications for humanitarian actors, health practitioners, and policymakers working in conflict-affected contexts.

This article proposes an integrated model for sustainable scale-up of the First 1,000 Days approach in fragile contexts, drawing on empirical findings from Niger's Tillabéry region and theoretical frameworks from implementation science, adaptive governance, and systems thinking. The research employed a mixed-methods design combining quantitative surveys with 306 mothers of children under two and qualitative interviews with 18 health workers and community health agents in urban (Tillabéry) and rural (Sansané Haoussa) contexts. The findings reveal critical implementation gaps: 93.5% of mothers have never heard of the approach, 54.9% cite lack of money as the primary barrier to adequate child feeding, and health workers report insufficient funding (100%), staff shortages (83.3%), and transport difficulties (93.8%). The integrated model addresses these challenges through seven strategic pillars: (1) institutional capacity strengthening, (2) sustainable financing mechanisms, (3) human resource development, (4) community engagement and empowerment, (5) digital health and monitoring systems, (6) adaptive governance and multisectoral coordination, and (7) resilience building in fragile contexts. The model emphasizes the interaction between institutional, community, and systemic factors while recognizing the specific challenges of fragile Sahelian environments. The article proposes an operational scale-up project (PREM-1000J) for the Tillabéry region, outlining objectives, activities, expected outcomes, and implementation phases. The project aims to strengthen sustainable implementation of the First 1,000 Days approach through capacity building, community mobilization, logistical strengthening, digital monitoring, and sustainable financing. The findings contribute to the literature on nutrition intervention scale-up in fragile contexts and provide actionable guidance for policymakers, technical partners, and community actors engaged…

The relationship between emergency response coordination and acute malnutrition reduction is critical for humanitarian policy and practice. This article presents empirical evidence on the impact of emergency response coordination on acute malnutrition reduction in Burkina Faso between June 2025 and June 2026. Drawing on a mixed-methods study of 400 participants across national, regional, district, and community levels, the research assesses the effectiveness of coordination mechanisms in improving nutritional outcomes. The findings reveal that while coordination mechanisms have contributed to improved response coverage and efficiency, significant gaps persist in coordination effectiveness. Effective coordination is associated with better coverage of interventions, reduced duplication, and improved timeliness of response. However, coordination faces significant challenges, including insufficient information sharing, fragmented planning, weak leadership, limited community engagement, and security constraints. The study identifies key factors associated with coordination effectiveness: leadership commitment, institutional capacity, resource availability, community engagement, and security conditions. The article argues that strengthening coordination requires investments in information systems, joint planning, leadership development, and community engagement, within a supportive policy and institutional environment. The findings have implications for humanitarian policy and practice in Burkina Faso and similar contexts.

The performance of health information systems (HIS) depends on multiple interconnected factors that determine their capacity to produce reliable, available, and effectively used data for decision-making. This article analyzes the factors influencing HIS performance in urban healthcare facilities in Cameroon using the PRISM (Performance of Routine Information System Management) framework. The analysis draws on a literature review conducted as part of a doctoral research study evaluating the effectiveness of HIS in improving healthcare service quality in Douala, Cameroon. Key factors are categorized into three domains: technical (hardware and equipment, software and tools, data collection tools, connectivity), organizational (leadership, governance, supervision, coordination, resource allocation), and behavioral (knowledge and skills, motivation, attitudes, confidence). Technical factors affecting HIS performance include insufficient computer equipment, poor internet connectivity, unreliable electricity supply, and inadequate equipment maintenance. Organizational challenges encompass weak leadership commitment, inadequate governance mechanisms, insufficient supervision, poor stakeholder coordination, and limited resource allocation. Behavioral factors include limited knowledge and skills among health workers, low motivation, negative attitudes toward data use, and lack of confidence in HIS. The article proposes a comprehensive framework for strengthening HIS performance through integrated interventions addressing technical, organizational, and behavioral dimensions. Successful HIS strengthening requires strong leadership, sustained political commitment, adequate resource allocation, capacity building, quality assurance mechanisms, supervision, stakeholder coordination, and a culture of data utilization.

Packaged drinking water in plastic sachets has become a common source of hydration in Cameroon, particularly in urban and peri-urban areas where access to safe drinking water is limited. However, the microbiological quality of these products remains uncertain. This study evaluated the prevalence of total and fecal coliforms in sachet drinking water sold across the ten regions of Cameroon and analyzed regional variations in contamination levels. A total of 520 sachet water samples from 28 manufacturing companies were collected from regional capitals and analyzed using membrane filtration on Violet Red Bile Lactose Agar (VRBLA) incubated at 37°C for total coliforms and 44°C for fecal coliforms. Results revealed that 305 samples (58.65%) were contaminated with coliforms. Total coliforms were detected in 282 samples (59%), while fecal coliforms were detected in 200 samples (41%). The North and Far North regions had the highest contamination rates (20.74% each), followed by the Center (14.94%), South-West (12.66%), Littoral and North-West (10.37% each), West (5.81%), East (2.07%), Adamaoua (1.24%), and South (1.04%). Coliform counts in positive samples ranged from <200 CFU/100 ml in 10 companies (35.71%) to >200 CFU/100 ml in 10 companies (35.71%), exceeding the detection threshold. The study concludes that sachet drinking water in Cameroon is frequently contaminated with coliforms, indicating poor microbiological quality and potential health risks. Regional disparities in contamination levels highlight the need for targeted interventions in high-risk areas.

The Integrative Self-Healing, Resilience and Self-Actualization Model (MIAGRA) is a structured self-guided therapeutic framework that integrates meditation, reflective reading, expressive writing, and creative activities to support emotional healing, psychological resilience, and self-actualization. Designed as a complementary, culturally adaptable, and low-cost intervention, it can be applied in clinical, community, educational, humanitarian, and digital settings. This article presents the theoretical foundations of the model, its conceptual structure, contexts of application, limitations, and research perspectives.

The scientific validation of medicinal plants is essential for their safe and effective integration into healthcare systems. This article presents the methodological framework for the preclinical validation of Sida rhombifolia L. (Malvaceae) for antidiarrheal use in Gabon. The research comprises four complementary components: an ethnopharmacological survey to document traditional uses; phytochemical analysis to identify bioactive compounds; biological activity testing to assess antimicrobial, antispasmodic, anti-inflammatory, and antioxidant activities; and toxicity assessment to evaluate safety. The expected outcomes include a comprehensive profile of the plant's traditional uses, phytochemical composition, biological activities, and safety margin. The article discusses the ethical considerations, including informed consent, authorization from relevant authorities, respect for traditional knowledge, and animal welfare standards. The methodological framework is designed to generate robust, reproducible evidence that can support the development of a standardized phytomedicine for the complementary treatment of diarrhea in Gabon.

Chlamydia trachomatis infection during pregnancy is associated with a range of adverse maternal and neonatal outcomes, yet screening and treatment are not routinely provided in many low-income countries, including Cameroon. This article synthesizes the evidence on the maternal and neonatal consequences of Chlamydia trachomatis infection in pregnancy and discusses the clinical implications for antenatal care in Cameroon. Drawing on the study findings from the Mifi District Hospital in Bafoussam, which reported a seroprevalence of 54.3 percent, the article reviews the literature on the obstetrical complications (preterm birth, premature rupture of membranes, postpartum endometritis), neonatal complications (ophthalmia neonatorum, chlamydial pneumonia), and long-term consequences of untreated infection. The analysis reveals that Chlamydia trachomatis infection during pregnancy significantly increases the risk of preterm birth (OR 2.3, 95% CI: 1.5-3.5), premature rupture of membranes (OR 2.1, 95% CI: 1.3-3.4), and postpartum endometritis (OR 2.5, 95% CI: 1.4-4.2). Neonatal complications occur in 30-50 percent of exposed infants, with ophthalmia neonatorum presenting at 5-14 days of life and chlamydial pneumonia at 2-19 weeks. The article concludes that routine antenatal screening for Chlamydia trachomatis is essential for preventing adverse pregnancy outcomes and that treatment with azithromycin is safe and effective during pregnancy. Policy recommendations for Cameroon are provided.

Despite the proven effectiveness of primary prevention interventions, their implementation in rural areas of low- and middle-income countries often falls short of expected outcomes. This article addresses the third specific objective of a broader HDR research project: to determine the approaches that have been implemented to optimize the effectiveness of primary prevention interventions in rural areas of Cameroon, with particular attention to the Mbalmayo health district. Drawing on the Socio-Ecological Model (Bronfenbrenner, 1979; McLeroy et al., 1988), the Diffusion of Innovations Theory (Rogers, 1962, 2003), and the RE-AIM Framework (Glasgow, Vogt, & Boles, 1999), the research synthesizes the literature on effective implementation strategies for primary prevention in rural African contexts. The analysis reveals that effective approaches operate at multiple levels: individual (tailored education, behavior change communication), interpersonal (peer education, family engagement), community (community mobilization, participatory planning, engagement of traditional leaders), organizational (health system strengthening, integration into routine services), and policy (intersectoral action, resource allocation). The RE-AIM framework is identified as the tool par excellence for evaluating whether interventions reach vulnerable populations, achieve their intended effects, are adopted by implementing organizations, are implemented with fidelity, and are maintained over time. The article concludes that optimizing the effectiveness of primary prevention interventions in rural Cameroon requires a multi-level, participatory, and contextually adapted approach.

The successful implementation of new educational technologies requires not only technical solutions but also effective management strategies that address the human dimensions of change. This article tests the hypothesis that the transformation of a simple imposed rule (control) into a shared compromise with users (autonomy) would be an effective strategy for the use of optical reader technology in examination management in MINSANTE-approved schools in Bafoussam, Cameroon. Drawing on the theory of joint regulation developed by Jean-Daniel Reynaud (1980), the research examines how the negotiation of rules between management and users can lead to more effective technology implementation. The analysis reveals that joint regulation occurs when rules are not simply imposed from above but are negotiated between managers and users, taking into account the perspectives, concerns, and expertise of both parties. In the context of optical reader technology implementation, joint regulation involves engaging teachers and administrators in the design of implementation processes, allowing for feedback and adaptation, and building consensus around the use of the technology. The article concludes that joint regulation is a more effective strategy than top-down control because it increases user buy-in, allows for local adaptation, builds ownership, and creates a foundation for continuous improvement. The hypothesis is empirically testable through comparative case studies of schools using different implementation approaches.

The successful implementation of new educational technologies requires not only technical solutions but also effective management strategies that address the human dimensions of change. This article tests the hypothesis that the transformation of a simple imposed rule (control) into a shared compromise with users (autonomy) would be an effective strategy for the use of optical reader technology in examination management in MINSANTE-approved schools in Bafoussam, Cameroon. Drawing on the theory of joint regulation developed by Jean-Daniel Reynaud (1980), the research examines how the negotiation of rules between management and users can lead to more effective technology implementation. The analysis reveals that joint regulation occurs when rules are not simply imposed from above but are negotiated between managers and users, taking into account the perspectives, concerns, and expertise of both parties. In the context of optical reader technology implementation, joint regulation involves engaging teachers and administrators in the design of implementation processes, allowing for feedback and adaptation, and building consensus around the use of the technology. The article concludes that joint regulation is a more effective strategy than top-down control because it increases user buy-in, allows for local adaptation, builds ownership, and creates a foundation for continuous improvement. The hypothesis is empirically testable through comparative case studies of schools using different implementation approaches.

This study focuses on the analysis of innovative approaches in community nutrition implemented in Burkina Faso between 2024 and 2025. It aims to understand the strategies developed at the community level to combat malnutrition and promote healthy eating, as well as their perceived effectiveness by the involved actors. An exploratory qualitative study was conducted in the Central-North, Sahel, and North regions. Data were collected through semi-structured interviews, participant observations, and document analysis, then processed using thematic analysis assisted by NVivo 12 software. The sampling was deliberate and involved health and nutrition professionals, NGO representatives, as well as members of beneficiary communities. The results show that the main innovative approaches include nutritional education (76.9% of participants, approximately 40), community vegetable gardens (15.4%, approximately 8), local food processing (23.1%, approximately 12), the use of products like moringa (34.6%, approximately 18), and participatory training sessions (19.2%, approximately 10). The progressive integration of information and communication technologies (ICT) also serves as an important lever for awareness and monitoring, notably through smartphones and mobile applications (about 30.8%, n≈16) as well as SMS and WhatsApp platforms (about 25.0%, n≈13). Analyses indicate an improvement in nutritional knowledge and diversification of eating practices among the majority of participants (69.2%, n≈36). However, the persistence of malnutrition is mainly associated with poverty (30.3%, n≈16), food insecurity (30.3%, n≈16), and structural and organizational constraints (15.6%, n≈8). In conclusion, innovative approaches in community nutrition seem relevant for improving the nutritional status of populations, but their effectiveness depends on strengthening community involvement, integrating…

Spontaneous abortion, defined as the natural termination of a pregnancy before the 20th week of amenorrhea, most often occurs in the first trimester. It is estimated that approximately 10 to 20% of confirmed pregnancies end in spontaneous abortion, although the actual figure may be higher due to undiagnosed early losses. Understanding the factors contributing to these events is essential for better guiding prevention, medical monitoring, and psychological support for affected women. Spontaneous abortion remains a frequent complication of pregnancy, particularly in the first trimester. Its causes are multifactorial, ranging from maternal age to infectious and socioeconomic factors.

Achieving SDG 3 (Good Health and Well-Being) requires ensuring healthy lives and promoting well-being for all at all ages, including access to safe, effective, quality, and affordable essential medicines and health services (Target 3.8). Traditional medicine, including herbal medicine, acupuncture, traditional birth attendance, bone-setting, and spiritual healing, is widely used globally, particularly in low- and middle-income countries, serving 60 to 80 percent of the population in some regions. However, traditional medicine integration into national health systems varies dramatically across countries, shaped by historical recognition, regulatory frameworks, research investment, medical education, and political will. This study conducts a comparative analysis of traditional medicine integration into national health systems in China and South Africa, two countries with rich indigenous medical traditions, contrasting colonial histories, and divergent policy trajectories. China has achieved the most comprehensive integration of traditional medicine into a national health system globally, with constitutional recognition, legal protection, health insurance coverage, and widespread integration into public hospitals and primary care. South Africa, despite having a diverse indigenous medical heritage and enabling legislation, faces significant implementation gaps, including slow registration of traditional healers, lack of integration into health insurance and medical education, and limited research funding. Using a qualitative comparative case study methodology, the study analyzes secondary data from government reports, WHO documents, peer-reviewed literature, and program evaluations over the period 2000 to 2025. The study finds that China's successful integration is attributable to strong political commitment, investment in research, education, quality control, and health insurance coverage. South Africa's integration lags due…

Achieving SDG 3 (Good Health and Well-Being) requires ensuring healthy lives and promoting well-being for all at all ages, with Target 3.3 calling for ending the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases. Diagnostic innovation, the development and deployment of rapid, accurate, affordable, and accessible diagnostic tests, is a critical determinant of infectious disease control, enabling early detection, appropriate treatment, transmission reduction, and antimicrobial resistance surveillance. However, diagnostic capacity varies dramatically across countries, shaped by health system infrastructure, research and development investment, regulatory pathways, intellectual property regimes, manufacturing capability, and public-private partnerships. This study conducts a comparative analysis of diagnostic innovation for infectious diseases in India and Brazil, two large middle-income countries with contrasting health systems, strong pharmaceutical and diagnostic industries, and leadership in global health diplomacy. India has emerged as the "pharmacy of the developing world" for generic medicines and is rapidly expanding diagnostic capacity through major manufacturers, public sector diagnostic networks, and a strong cost-innovation model. Brazil has a universal public health system (SUS) serving 150 million people, with strong diagnostic infrastructure including Fiocruz (Oswaldo Cruz Foundation), Instituto Butantan, and a decentralized network of public health laboratories (LACEN). Brazil has pioneered molecular testing integration for multiple pathogens and led a brain infections intervention study (Lancet 2025) that increased syndromic diagnosis from 77 percent to 86 percent and microbiological diagnosis from 22 percent to 30 percent across 13 hospitals in Brazil, India, and Malawi. Using a qualitative comparative case study methodology, the study analyzes secondary data from…