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Cet ouvrage collectif présente les analyses et les expériences scientifiques de plusieurs chercheurs et chercheuses sur les traumatismes routiers en Afrique. L’ambition de l’ouvrage est de rassembler en langue française les rares connaissances produites sur ce sujet en Afrique. Les thèmes sont variés et convergent vers trois axes principaux, celui de l’amélioration des données sur les accidents de la route, de l’enjeu de santé publique que constituent les traumatismes routiers et enfin de l’importance du transfert de connaissances pour aider à élaborer des politiques de sécurité routière adaptées aux contextes des pays. Les traumatismes routiers constituent aujourd’hui une épidémie oubliée sur le continent qui devra pourtant être maitrisée si les États veulent atteindre l’une des cibles des objectifs pour le développement durable consacrée à la réduction de moitié des blessé·e·s et des décès sur les routes.

Parmi les villes ouest-africaines, Ouagadougou est une particularité. Les transports en commun, reposant sur l’intervention étatique, et malgré plusieurs efforts, peinent à se développer. La capitale burkinabè est une de celles où les déplacements à pied sont les plus faibles et où les moyens de transport privés, par deux roues motorisés, sont les plus utilisés dans les mobilités quotidiennes. Pourtant, dans ce paysage, le transport par taxi s’est maintenu au cours des décennies. Estimé à un millier dans les années 1990, leur nombre dépasserait 5000 en 2020. La question est de comprendre les caractéristiques de ce développement et les raisons du maintien de ce transport collectif. La méthodologie de ce travail repose sur une approche géographique (géoréférencement des gares de taxi) et qualitative (entretiens auprès d’un échantillon de taximen et de client·e·s). La fonction artisanale de ce moyen de déplacement, très sollicité dans les activités économiques (transport de marchandises) et sociales (déménagement, évacuation sanitaire), justifie sans doute cette continuité et le déploiement limité des gares de taxi sur le territoire urbain. Il révèle ainsi la ville active, mais également les insuffisances des équipements et les inégalités sociales, en tant que moyen de transport des populations les plus modestes.

In this commentary, we present a follow-up of two articles published in 2017 and 2018 about road traffic crashes, which is an important public health issue in Africa and Burkina Faso. The first article reported on a research project, conducted in partnership with local actors involved in road safety, carried out in Ouagadougou in 2015. Its aim was to test the effectiveness, acceptability, and capacity of a surveillance system to assess the number of road traffic crashes and their consequences on the health of crash victims. Several knowledge translation activities were carried out to maximize its impact and were reported in the 2018 article published in HRPS: monthly reports presenting the research data, large-format printed maps distributed to the city’s police stations, and a deliberative workshop held at the end of the research project. The present commentary presents our efforts to deepen our understanding of the impacts of the knowledge translation strategy, based on follow-up interviews, 18 months after the workshop, with the heads of the road traffic crash units in Ouagadougou police stations (n = 5). Several benefits were reported by respondents. Their involvement in the process prompted them to broaden their knowledge of other ways of dealing with the issue of road crashes. This led them, sometimes with their colleagues, to intervene differently: more rapid response at collision sites, increased surveillance of dangerous intersections, user awareness-raising on the importance of the highway code, etc. However, sustaining these actions over the longer term has proven difficult. Several lessons were derived from this experience, regarding the importance of producing useful and locally applicable research data, of ensuring the acceptability of the technologies used for data collection, of using collaborative approaches in research and knowledge translation, of ensuring the visibility of actions undertaken by actors in the field, and of involving decision-makers in the research process to maximize its impacts.

Au Burkina Faso, la naissance de jumeaux contraint leurs meres a un rite de presentation des enfants, lors duquel elles recoivent des offrandes. Cet article a pour objectif d’interroger l’evolution de cette pratique en une forme de mendicite des meres de jumeaux autour des mosquees en contexte urbain. Ouagadougou a constitue le terrain d’observation des lieux de mendicite. Les resultats font apparaitre les mosquees comme lieux privilegies de convergence de mobilites feminines en lien avec une mendicite pourtant non dependante des pratiques religieuses islamiques et une mutation de l’economie morale du don au niveau local.

Each year, more than 1.2 million deaths in the world are due to road accidents. It is the leading cause of mortality in young people between the ages of 15 and 29 years. Road accidents and associated injuries have a major impact on health and development. Many international reports have evaluated the mortality and morbidity related to road accidents, but these studies are based on limited data, often with limited robustness. Based on a study conducted in Ouagadougou, the capital of Burkina Faso, to estimate the mortality and morbidity of road accident victims, the objective of this article was to evaluate social, spatial and health inequalities of populations killed or injured as a result of a road accident.Between February and July 2015, all road accidents were recorded by policemen using a mobile telephone data collection system, including geolocation of accidents. Three quantitative and prospective survey phases were then performed on injured patients admitted to Yalgado Ouedraogo hospital, the reference centre for these patients.A total of 1,867 emergency department admissions were reported. The majority (95%) of road accident victims were vulnerable users. More than 30% of accidents occurred in one central quarter and two peripheral quarters. The mean management time as 1 hour 3 minutes for victims rescued by firemen and 3 hours 10 minutes for those who attended the emergency department on their own. The mean total cost of management was 126,799 CFA francs (€193) [400-2,000,000 CFA francs].These results identify possible actions designed to reduce road accident injuries and their consequences. They demonstrate that the creation of surveillance systems common to police forces, rescue and health care services are essential to produce convincing data.

La recherche interventionnelle en santé mondiale est souvent effectuée au moyen de partenariats scientifiques internationaux. Mais la réalisation de telles recherches, notamment dans les pays à faible revenu où les enjeux de pouvoir, d’argent et de relations interculturelles sont exacerbés, soulève de nombreux défis éthiques, notamment concernant la conduite responsable lors des recherches collaboratives. L’un d’eux est la conservation, l’accès, l’utilisation et la publication des données. Malgré l’existence de multiples politiques et documents phares sur l’éthique et la conduite responsable de la recherche, les chercheurs en recherche interventionnelle sont encore peu outillés pour faire face à ce défi. Dans le contexte d’un programme de recherches interventionnelles réalisées au Burkina Faso, les auteurs souhaitent partager leur expérience dans le développement d’une politique interne concernant leurs données. Après avoir évoqué le contexte global et particulier, l’article présente le processus de formulation et d’adoption de cette politique par les chercheurs d’une équipe interdisciplinaire et internationale (Allemagne, Burkina Faso, Canada, France). Les valeurs qui enchâssent cette politique interne sont la transparence, la prévention, le consensus autour du processus de production, le respect des principes internationaux, l’accès libre aux connaissances produites et la préoccupation pour leur diffusion et utilisation. La politique se présente en plusieurs parties : objet, types et statuts des chercheurs impliqués, conservation des données, accès et utilisation des données, production scientifique et paternité. Les principaux défis rencontrés par les chercheurs pour formuler cette politique sont analysés dans un souci de partage pour susciter un débat rarement abordé. La confiance, la transparence et le respect mutuel doivent être au cœur de tout partenariat scientifique en recherche interventionnelle., Interventional global health research is often carried out through international scientific partnerships. However, the conduct of such research, especially in low-income countries where issues of power, money and intercultural relations are exacerbated, raises many ethical challenges particularly related to responsible conduct in collaborative research. One of these challenges is the storage, access, use and publication of data. Despite the existence of multiple influential policies and documents on ethics and the responsible conduct of research, researchers in intervention research are still not equipped to deal with such challenges. In the context of an intervention research program conducted in Burkina Faso, the authors would like to share their experience in the development of an internal policy concerning their data. After presenting the global and the particular context, the paper presents the process of policy formulation and its adoption by the researchers of an interdisciplinary and international team (Burkina Faso, Canada, France, Germany). The values that entrench this internal policy are: transparency, prevention, consensus about the production process, respect for international principles, free access to the knowledge produced and concerns regarding its dissemination and use. The policy is presented in several parts: aim, types and status of the participating researchers, data storage, access and use of data, scientific production and authorship. The main challenges faced by researchers in formulating this policy are analyzed in a shared desire to spark a debate that is rarely addressed. Trust, transparency and mutual respect should be central to any scientific partnership in intervention research., Article

Introduction : Chaque annee, plus de 1,2 million de deces sont dus aux accidents de la route dans le monde. C’est la premiere cause de mortalite des jeunes de 15 a 29 ans. Les accidents de la route et les traumatismes associes ont un impact majeur sur la sante et le developpement. De nombreux rapports internationaux evaluent la mortalite et la morbidite des accidents, mais ces etudes reposent sur une faible disponibilite des donnees, souvent peu robustes. A partir d’une recherche realisee a Ouagadougou, la capitale du Burkina Faso, pour estimer la mortalite et la morbidite des accidentes de la route, l’objectif de cet article est d’evaluer les inegalites sociales, spatiales et sanitaires des populations blessees ou tuees lors d’un accident de la route.Methodes : Entre fevrier et juillet 2015, un enregistrement des accidents de la route par les policiers a ete realise en utilisant un systeme de collecte par telephonie mobile incluant la geolocalisation des accidents. Trois phases d’enquetes, quantitatives et prospectives, ont ensuite ete realisees aupres des blesses transferes a l’hopital Yalgado Ouedraogo, le centre de reference pour ces patients.Resultats : Au total, 1 867 entrees aux urgences ont ete recensees. La majorite (95 %) des blesses etait des usagers vulnerables. Un quartier central et deux peripheriques concentrent plus de 30 % des accidents. Le temps de prise en charge moyen est de 1 h 03 pour les victimes secourues par les pompiers et de 3 h 10 pour ceux qui s’y rendaient seuls. Le cout total moyen de la prise en charge est de 126 799 F CFA (193 €) [400-2 000 000 F CFA].Discussion : Ces resultats identifient les leviers d’actions possibles pour reduire les traumatismes de la route et ses consequences. Ils demontrent que la mise en place de systemes de surveillance communs aux forces de police, aux services de secours et de soins sont indispensables pour produire des donnees probantes.

Background: In the early 2000s, electronic surveillance systems began to be developed to collect and transmit data on infectious diseases in low-income countries (LICs) in real-time using mobile technologies. Such surveillance systems, however, are still very rare in Africa. Among the non-infectious epidemics to be surveilled are road traffic injuries, which constitute major health events and are the fifth leading cause of mortality in Africa. This situation also prevails in Burkina Faso, whose capital city, Ouagadougou, is much afflicted by this burden. There is no surveillance system, but there have been occasional surveys, and media reports of fatal crashes are numerous and increasing in frequency. Objective: The objective of this article is to present the methodology and implementation of, and quality of results produced by, a prototype of a road traffic crash and trauma surveillance system in the city of Ouagadougou. Methods: A surveillance system was deployed in partnership with the National Police over a six-month period, from February to July 2015, across the entire city of Ouagadougou. Data were collected by all seven units of the city’s National Police road crash intervention service. They were equipped with geotracers that geolocalized the crash sites and sent their positions by SMS (short message service) to a surveillance platform developed using the open-source tool Ushahidi. Descriptive statistical analyses and spatial analyses (kernel density) were subsequently performed on the data collected. Results: The process of data collection by police officers functioned well. Researchers were able to validate the data collection on road crashes by comparing the number of entries in the platform against the number of reports completed by the crash intervention teams. In total, 873 crash scenes were recorded over 3 months. The system was accessible on the Internet for open consultation of the map of crash sites. Crash-concentration analyses were produced that identified ‘hot spots’ in the city. Nearly 80% of crashes involved two-wheeled vehicles. Crashes were more numerous at night and during rush hours. They occurred primarily at intersections with traffic lights. With regard to health impacts, half of the injured were under the age of 29 years, and 6 persons were killed. Conclusions: This pilot study demonstrated the feasibility of developing simple surveillance systems, based on mHealth, in LICs.

La relation entre mobilité et extension urbaine a donné naissance à plusieurs modèles de ville. Les pratiques d’aménagement, fortement dépendantes de l’automobile, ont participé au processus d’étalement urbain caractéristique des pays du nord. Ce modèle observé également dans les capitales africaines repose toutefois sur des modes de déplacements très variés, sources d’une grande vulnérabilité pour les usagers et d’un nombre élevé de traumatismes issus des accidents de la route. Cet article vise à comprendre en quoi l’aménagement urbain participe de cette vulnérabilité dans la capitale du Burkina Faso, Ouagadougou. L’étude repose sur la géolocalisation des lieux d’accidents et des entrevues réalisées auprès des acteurs communaux. Les résultats montrent un lien fort entre étalement urbain et importance des accidents de la route de façon originale puisqu’ils sont caractéristiques des axes revêtus. Le développement de l’habitat est au coeur des politiques urbaines, la question de la mobilité est beaucoup plus récente, imposée par la croissance démographique. Cependant, la politique des transports en commun reste embryonnaire, le moyen de déplacement privilégié est le deux roues. Le pouvoir local ne semble pas avoir pour vocation de protéger les populations vulnérables en circulation, la valeur dominante en matière de conception du réseau routier reposant sous la garantie d’une mobilité toujours plus fluide et négligeant la sécurité routière. L’extension du réseau bitumé apparaît donc comme un facteur favorable à la multiplication des accidents de la route au Burkina Faso., The interconnection between mobility and urban expansion has given rise to many different city models. Urban development practices that are strongly automobile-dependent have contributed to the process of urban sprawl that is characteristic of Northern countries. This model is also seen in African capitals; however, there it is based on a wide variety of modes of transportation, a situation of great vulnerability for users and resulting in a high number of traumatic injuries from road accidents. The aim of this article is to understand how urban development contributes to this vulnerability in the capital city of Burkina Faso, Ouagadougou. The study was based on geolocalization of crash sites and on interviews with local actors. The results showed, in an innovative way, a strong link between urban sprawl and amount of traffic crashes, as such accidents are typical of paved roadways.Residential development is the core focus of urban policies in Ouagadougou, with the issue of mobility being much more recent, imposed by demographic growth. However, because urban public transport policy is still in its early stages, most people still rely on two-wheeled vehicles for transportation. Local authorities do not appear to see the protection of vulnerable populations in traffic as their mandate. In designing the road network, their dominant preoccupation seems to centre on always ensuring faster flow, while road safety is neglected. The expansion of the paved road network thus appears to be a factor in increasing the number of road traumas in Burkina Faso.

Burkina Faso has experienced significant aggregate growth over the past two decades, but the growth has not transformed into poverty reduction. Key obstacles preventing escape from poverty are high population growth, combined with the absence of major technological change in agriculture and any significant structural transformation of the urban economy. Continuously rising food prices and droughts maintain child malnutrition and mortality at high levels, threatening political and social stability. The growth had basically two sources: a massive migration of people from the rural agricultural sector to the urban informal sector, and agricultural production of food crops and cotton, both fuelled by a massive expansion of cultivable land. Dealing with Malthusian forces is the main challenge for Burkina Faso in the decade to come.

Lot of definitions are used to describe the slums. But words do not cover the same realities. In Ouagadougou, different authors used different words to talk about spaces marked by lack of land tenure security. But sometimes, other characteristics are not so different from some legal areas of the subdivided city.

Introduction En Afrique de l’Ouest, les bases de données géographiques ne font pas l’objet d’une production fréquente et systématique. Elles sont plus généralement produites dans le cadre de programmes ponctuels, qu’ils soient consacrés à la recherche ou réalisés dans le cadre de consultations ou d’étude territoriales. En conséquence, la mise en commun et la réalisation d’observatoires sont rares. S’il existe des projets généraux environnementaux comme SIG Afrique ou des SIG dédiés à des proj...

Burkina Faso has experienced quite significant aggregate growth over the past two decades, but that growth has not been transformed into poverty reduction. The key obstacles preventing large-scale escape from poverty are very high population growth combin

Over recent decades, Burkina Faso has improved the geographic accessibility of its health centres. However, patients are still required to pay point-of-service user fees, which excludes the most vulnerable from access to care. In 2010, 259 village committees in the Ouargaye district selected 2649 indigents to be exempted from user fees. The 26 health centre management committees that fund this exemption retained 1097 of those selected indigents. Spatial analysis showed that the management committees retained the indigents who were geographically closer to the health centres, in contrast to the selections of the village committees which were more diversified. Using village committees to select indigents would seem preferable to using management committees. It is not yet known whether the management committees’ selections were due to a desire to maximize the benefits of exemption by giving it to those most likely to use it, or to the fact that they did not personally know the indigents who were more geographically distant from them, or that some villages are not represented at the management committees.

The Ouagadougou Health and Demographic Surveillance System (Ouaga HDSS), located in five neighbourhoods at the northern periphery of the capital of Burkina Faso, was established in 2008. Data on vital events (births, deaths, unions, migration events) are collected during household visits that have taken place every 10 months. The areas were selected to contrast informal neighbourhoods (similar to 40 000 residents) with formal areas (similar to 40 000 residents), with the aims of understanding the problems of the urban poor, and testing innovative programmes that promote the well-being of this population. People living in informal areas tend to be marginalized in several ways: they are younger, poorer, less educated, farther from public services and more often migrants. Half of the residents live in the Sanitary District of Kossodo and the other half in the District of Sig-Nonghin. The Ouaga HDSS has been used to study health inequalities, conduct a surveillance of typhoid fever, measure water quality in informal areas, study the link between fertility and school investments, test a non-governmental organization (NGO)-led programme of poverty alleviation and test a community-led targeting of the poor eligible for benefits in the urban context. Key informants help maintain a good rapport with the community. The Ouaga HDSS data are available to researchers under certain conditions.