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Model of organisation and functioning sseb

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par KENGNE Jeanne d'Arc
Madison University - Bachelor 2008
  

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I.2. FRAMEWORK OF THE CONCEPT

The conceptual model below on the participation of the population in the framework of health system integration as sub-system of the local council socio - economic system has served as reference [1].

This diagram of management and animation shows that from resources (relatively) limited and with considerable problems, a rational management of health is a must. This means an efficient and effective management.

Among available resources, there is the use of human potential, which is indispensable in the increase of efficiency and effectiveness of the treatment management. Health is not a general good in itself; it only makes sens when seen as a contribution to human promotion. As shown in the first diagram :

(a) Is the objective of health service and direct contribution to development; (a) does not have any sense if:

(b) does not develop itself in parallel to it.

(c) Is the health service contribution by a non specific way to development.

(d) Is the responsibility of a number of services among which health service must be part.

However, for various reasons, the study of this interface did not lay prior emphasis on research activities on health system.

Obstacles
Met

Methods to
use

Long term
objectives

Global aim

(d)

Figure 1: Management diagram: global approach of health problems in the

Importance of problems HIV/AIDS -

M alnutrition - Transmissible diseases

Lack of opportunities

leading to a fatalistic attitude

Lack of resources Qualified personnel - finances- furniture infrastructure - etc.

MEDICAL AND
HEALTH ANIMATION

M ANAGEM ENT Optimal use of resources

(Human resources)

(c)

GLOBAL SOCIAL A NIM ATION

&

SOCIO
ECONOM IC
DEVELOPMENT

Rise of the living standard

HEALTH

(b)

(b)

(a)

HUMAN
PROMOTION

Studies on the integration of population « health » preoccupations in a huge complete package where other socio-economic structures interact with the health action [1] have described how from problems met at the level of the interface health service / population one can initialize a dialogue with other existing socio-economic structures to »coordinate» the inter sector action. The relation of the medical and health animation with social animation (c) and socio-economic development (d) can only express itself by «the integration» of the health system in a whole complete package (figure 1) [1].

Other concepts range health and well -being in an ecologic approach based on the principle that they are two intimately linked elements and that they are determined by multiple conditions that interact on one another (people's way of life, their social milieu the same as their environment) [2].

In addition, studies on the analysis of various treatment systems describe various models of integration system and how they can be coordinated [3].

In reference to primary health care [4] and to health district [5] [3] [6] as defined by the WHO, the participation of the populations is erected as a pillar of health services delivery. The health centre is considered as the element of the district health service whose specificity in primary health care is to be the point of interaction between the service and a defined community to which it delivers global health care, that is, complete, continuous and integrated1 [5] [7].

Many studies also place the importance of participation in the policy and practices for the promotion of health because it enables communities to identify problems, propose solutions and favour change [8].

With the advent of AIDS pandemic, the youths are highly exposed to the risk of contracting HIV. They are in the heart of this pandemic. Their participation to HIV prevention programmes has been identified as being an essential feature for the success of programmes that have recognized them [9]. The participation of the youths to questions in which they are involved is a right stipulated in the Convention of Rights of Children (CRC) [10].

I.3. DESCRIPTION OF THE CONTEXT 2

The pilot experience was developed in Bangui, the capital city of the Central African Republic with an estimated population of 670,000 inhabitants divided up into eight districts. The third district covers an area of 510 hectares with an estimated population of 134, 000 inhabitants among which 53, 000 young people of 10 to 24 years old (40%). It is divided into two groupings and twenty-nine quarters with eight main ethnic groups. The socio-educative infrastructure comprises eight primary schools (among which five are public), four Islamic

1 Comprehensive (whole) health care (globalité): illnesses are considered in their total dimension (including social and economic dimensions).

Continuity of health care: treatments are organized to follow service users' right from the beginning to the end of their illness or their risky episode as well as to follow the whole health needs of the community.

Integrated health care: promotion, prevention and education activities are complementary to curative activities and they are integrated to socio-economic development.

2 Data provided by the third district council of Bangui

schools for the study of the holy Quran, two secondary schools (all of them public), two youth clubs, nine health centres (among which two are public), an HIV voluntary testing centre, a sector for social action comprising eight nursery schools (among which two are public), four catholic parishes, twenty -two protestant parishes, six mosques, a police station, a gendarmerie (French police station), a post and telecommunication service, a taxation service, a « Crédit Mutuel de Centrafrique » desk, and two playgrounds.

3

12

Figure 2 : The administrative map of the city of
Bangui

Figure 3 : The administrative map of the third
district of Bangui

3

Third district

II. GLOBAL APPROACH OF PROBLEMS IN THE PREVENTION OF RISK AND VULNERABILITY TO HIV/AIDS OF YOUTH IN THE THIRD DISTRICT OF BANGUI: OBJECTIVES AND PROCESS

II.1.OBJECTIVES

Three main objectives have been defined in the framework of this pilot experience:

1. to study the organisation-management conditions and methods of the comprehensive responsibility (integrated, continuous and whole) of youth risk and vulnerability related to STI/HIV/AIDS with their full and active participation;

2. to exploit collected data for documentation ;

3. to provide to authorities in charge (of youth education)with useful information for the generalisation of the model in the whole country.

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