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The success of strategies to revitalize primary health care services such as those advocated by the Bamako Initiative requires a response adapted to the expectations of the population, especially in terms of quality. The goal of this study, conducted in two rural communities in Guinea, was to identify, characterize, and classify the criteria that the public(More)
INTRODUCTION Methodologies that have been developed and validated in accordance with accepted scientific standards are needed to monitor and assess the quality of primary health care in developing countries. OBJECTIVE To present the results of reliability and validity testing of a new instrument of measurement intended to document the user's opinion on(More)
OBJECTIVE To determine individual and contextual factors associated with emergency obstetric and neonatal care (EmONC) competency among primary healthcare staff in Mali. METHODS Between November 2011 and April 2012, a competency test was administered to 196 healthcare workers in 65 community health centers in Mali. The test was scored from 0 to 100, and(More)
OBJECTIVES Antifungal prescription practices have changed over the last decade, and the impact of these changes is unclear. Our objective here was to evaluate the effect of antifungal drug use on the distribution and drug susceptibility of Candida spp. in a French intensive care unit (ICU). METHODS Antifungal drug use was measured as the number of defined(More)
OBJECTIVE To evaluate the effect of a national referral system that aims to reduce maternal mortality rates through improving access to and the quality of emergency obstetric care in rural Mali (sub-Saharan Africa). METHODS A maternity referral system that included basic and comprehensive emergency obstetric care, transportation to obstetric health(More)
BACKGROUND Maternal mortality is higher in west Africa than in most industrialised countries, so the development and validation of effective interventions is essential. We did a trial to assess the effect of a multifaceted intervention to promote maternity death reviews and onsite training in emergency obstetric care in referral hospitals with high maternal(More)
The authors report a case of wave-burst arrhythmia which occurred during combined treatment with terfenadine and troleandomycin. After the treatment had been stopped and the QT interval returned to normal, terfenadine treatment was reintroduced with no major change in repolarization. However, as soon as troleandomycin was associated, there was a significant(More)
PURPOSE To evaluate the biomechanical and morphological changes in keratoconic corneas after Intacs intrastromal corneal ring segment (ICRS) implantation. SETTING Department of Ophthalmology, National Reference Center for Keratoconus, Bordeaux University, Bordeaux, France. METHODS Keratoconic eyes were retrospectively analyzed after ICRS implantation;(More)
Many developing countries, particularly in Africa, have recently introduced payment schedules based on the selling of essential drugs. This is one of the main elements of the Bamako Initiative according to which the income generated would ensure a reliable supply of drugs and would improve other aspects of the quality of the services offered. Thus, quality(More)