Literatura académica sobre el tema "Exode rural – Antananarivo (Madagascar)"

Background: Pre-eclampsia is a human-pregnancy-specific disease defined as the occurrence of hypertension and significant proteinuria in a previously healthy woman on or after the 20th week of gestation. It is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. The aim of this study is to determine the prevalence of pre-eclampsia and to evaluate its maternal and fetal outcomes in a rural area.Methods: This is a cross-sectional study carried out at the Bejofo Mahitsy hospital. It is a District Hospital Referral Center, which is located on the outskirts of the capital, 32 km from Antananarivo, Madagascar. This work was carried out during 24 months, from January 2014 to December 2016. We have included all hospitalized pregnant patients with SBP ≥140 or DBP ≥90mmHg, significant proteinuria> 300mg/24H with or without edema.Results: During this period, we recorded 97 cases of pre-eclampsia, frequency of 1.68%. The mean age of the parturient was 28 years old and 46.39% of the patients were primiparous. At the admission to the hospital, 37 (38,14%) did not show any particular signs. Concerning the severe high blood pressure, 47 pregnant patients (48,46%) had SBP greater than 160 mm Hg and 26 womens (26,80%) had DBP greater than 110 mm Hg. Caesarean section was the method of delivery widely adopted in 74.22 %. Maternal morbidity was represented by eclampsia in 21.65%, Retroplacentary Hematoma in 3% and HELLP syndrome in 4.12%. Fetal morbidity was important with 35% of premature newborns, 25.77% was small for gestational age and 12.37% was with neonatal asphyxia. Intra uterine fetal mortality was found in 11.34% and the perinatal mortality rate was 8.73%.Conclusions: There is a high frequency of pre-eclampsia in our setting and the consequences of pre-eclampsia for neonatal mortality and morbidity outcome are alarmingly high pre-eclampsia. Prevention necessarily involves quality prenatal follow-up such as screening, early and appropriate care of hypertension during pregnancy.

BackgroundThe importance of addressing malnutrition is increasing in the context of children’s health and their academic performances. Childhood malnutrition further could reduce a country’s economic productivity. No earlier study adequately estimated the causalities between schoolchildren’s malnutrition and their academic performances. How nutritional status contributes to children’s academic performances has never been reported from Madagascar. This study aims to estimate the possible causalities between their nutritional status and academic performances in rural Madagascar.MethodsA cross-sectional household survey was conducted in Antananarivo-Avaradrano district, Madagascar, from November to December 2017, by targeting 404 first and second graders 5–14 years of age enrolled in 10 public primary schools. Children’s anthropometric measurements and structured interviews with their mothers/caregivers were conducted. Children’s academic performances data (mathematical and national language proficiencies) were collected at each school. To estimate associations between their malnutrition and academic performances, bivariate and multivariate analyses were conducted. To estimate their possible causalities between them, three conditions were examined (crude covariational relationship, covariational relationship through controlling for a third variable and temporal precedence).ResultsFour independent variables produced significantly positive coefficients with mathematical proficiency in multivariate analysis. Of the four, ‘not being stunted’ and ‘attendance rate’ were estimated to be possible causes of higher mathematical proficiency because they satisfied all the three conditions for a causality. On the other hand, three independent variables produced significantly positive coefficients with national language proficiency in multivariate analysis. Yet, none of them were estimated to be possible causes of higher national language proficiency.ConclusionsA hypothetical causal path indicates that ‘not being stunted’ is likely to have caused higher ‘attendance rate’ and thereby higher ‘mathematical proficiency’ in a two-step manner. This study is the first attempt to estimate the possible causalities between schoolchildren’s nutritional status and their academic performances in Madagascar.

High urbanization rates in cities lead to rapid changes in land uses, particularly in southern cities where population growth is fast. Urban and peri-urban agricultural land is often seen as available space for the city to expand, but at the same time, agricultural land provides many benefits to cities pertaining to food, employment, and eco-services. In this context, there is an urgent need to provide spatial information to support planning in complex urban systems. The challenge is to integrate analysis of agriculture and urban land-cover classes, and of their spatial and functional patterns. This paper takes up this challenge in Antananarivo (Madagascar), where agricultural plots and homes are interlocked and very small. It innovates by using a methodology already tested in rural settings, but never applied to urban environments. The key step of the analysis is to produce landscape zoning based on multisource satellite data to identify agri-urban functional areas within the city, and to explore their relationships. Our results demonstrate that the proposed classification method is well suited for mapping agriculture and urban land cover (overall accuracy = 76.56% for the 20 classes of level 3) in such a complex setting. The systemic analysis of urban agriculture patterns and functions can help policymakers and urban planners to design and build resilient cities.

O ensaio trata do início de meu trabalho de campo, em 1990, em uma comunidade rural malgaxe, localizada a uma hora por carro da capital Antananarivo. A comunidade estava, naquela época, tomada por uma intensa guerra simbólica entre andriana – descendentes do que se pode chamar clã nobre – e mainty, descendentes dos ex-escravos daqueles. A luta ganhou ainda mais significado quando percebi que o estado malgaxe tinha, por vários interesses e propósitos, se retirado de comunidades rurais como aquela, mas membros delas estavam engajados em um jogo sutil de apropriação da representação do que era visto como um poder estatal predatório e coercitivo, de modo a defender-se dele, um hábito que tornou muito difícil de perceber o fato de que comunidades rurais estavam efetivamente se auto governando. Abstract The essay recounts the beginning of my fieldwork in a Malagasy rural community an hour’s drive from the capital of Antananarivo in 1990. The community itself was, at the time I arrived, locked in a kind of intense symbolic warfare between andriana – descended from what might be called a noble clan – and mainty, the descendants of their former slaves. The struggle took on all the more significance when I came to understand that the Malagasy state had, for most intents and purposes, effectively withdrawn from such rural communities, but that members of those communities were engaged in a subtle game of appropriation of the representatives of what was seen as a predatory and coercive state power so as to fend it off, a habit that made the fact that rural communities were now effectively self-governing very difficult to perceive.

Abstract Background Little is known about the epidemiology and associated factors of childhood AD in the markedly different, low-income, tropical environment like Madagascar. Methods We aim to assess the epidemiology and associated factors of AD in individuals fewer than 15 years of age in Antananarivo Madagascar. It was a retrospective and descriptive study over a period of 7 years (2010 to 2016) in children 6 months to 14 years in the Department of Dermatology, Joseph Raseta Befelatanana Antananarivo Madagascar. The diagnosis of AD was based on clinical data. Results The prevalence of AD was 5.6% in children aged 6 months to 14 years. The details of 151 cases of atopic dermatitis were analyzed. The mean age of patients was 4 years. There was a female preponderance (sex ratio: 0.7). A family history of AD was noted in 56 cases (37%). No association between breast-feeding and AD was found. The age of onset of AD was before the age of 3 months in 7.5% and between 6 months to 5 years in 70%. Children born in March (dry season) had the highest risk of AD. Consultations for AD increased during the winter (from July to October; p = 0.005). However, the prevalence of AD was similar in urban and rural areas. Conclusion Weather may have an impact on the prevalence of atopic dermatitis in Madagascar. No significant correlation was found between the duration of breastfeeding and AD, as well as urbanization.

AbstractThe management of preterm births remains a major challenge in Madagascar, given the lack of equipped facilities in rural areas, and the absence of precise data concerning the incidence of such births. The World Health Organization (WHO) recommends the kangaroo method (skin-to-skin contact) for the management of preterm infants. In this article, we examine the conditions for success and the obstacles facing kangaroo care in community settings in Madagascar. We performed a qualitative research, collecting data from the districts of Antananarivo and Mahajanga in 2021. In total, 54 semi-structured interviews and two focus group sessions were conducted with the parents of preterm infants and healthcare professionals.The obstacles identified by the research included incomplete and inaccurate knowledge, leading to heterogeneity in the practice of kangaroo care: arbitrary duration, lack of kangaroo care at night, exclusive breastfeeding, and only partially practiced skin-to-skin contact. We found that the conditions for success depended on: (1) the healthcare system, (2) local interpretations of pregnancy, and (3) the structure of the infant’s family. Failings of the medical system, cultural habits going against kangaroo care, and “nuclear” and/or “single parent” family structures undermine the application of this practice, jeopardizing upscaling efforts. We hope that the results of this research will guide community strategies for the management of preterm infants and kangaroo care.

Abstract Although the children malnutrition in Madagascar and the environmental pollution of this country has been widely discussed, there is no research on the differences in toxic elements accumulation in human body in dependence on nutritional status of Malagasy. Nine elements concentration (Al, As, Cd, Cr, Hg, Ni, Pb, Sn and Sb) was determined in scalp hair of 103 schoolgirls (8–15 years old), living in two areas: urban – close to Antananarivo (UR) and rural Berevo region (RU). Samples were analysed by an inductively coupled plasma optical emission spectrometer. The nutritional status was evaluated by Cole’s index. Underweight was related to higher accumulation of Al, Cd and Cr in the hair girls, and more common among girls living in RU than UR region (42 % v. 28 %). Two-factor ANOVA showed differences in the Al and Cr content in the girls’ hair depending both on their place of residence and nutritional status. This indicates additional consequence of malnutrition to the girls development and health.

L'objet de mon travail de thèse est l'analyse des processus qui tendent à maintenir les femmes malgaches dans la subordination et dans la dépendance à l'égard des hommes lorsqu'elles migrent en vue d'améliorer leur sort et celui de leur famille. Mon intention est de rendre compte des expériences rencontrées dans le cadre de leur migration afin de saisir ce qui entrave leur quête de sécurisation et les maintient dans une précarité matérielle et positionnelle vis-à-vis des hommes. Au-delà des différences de positions socioéconomiques d'origine et du type de migration effectué par ces femmes, les oppressions qu'elles subissent restent analogues. Les circonstances pour s'en extraire dépendent des possibilités de sécurisation qu'offre le lieu de migration. La première partie concerne l'exode rural qui a emmené des femmes, à s'installer dans les quartiers pauvres d'Antananarivo (la capitale de Madagascar). Cette migration interne, qu'elle soit amorcée par une stratégie familiale de survie ou par un choix individuel émanant des femmes elles-mêmes, n'aboutit pas à la sécurisation de leur condition de vie. Les épreuves familiales et personnelles démontrent la vulnérabilité des parcours de vie dès lors où les femmes sont détachées du système d'entraide familial. L'impossible retour au village, combiné avec les difficultés de trouver des ressources définissent leur situation limitrophe entre une paysannerie qui les a rejetées et un monde urbain difficile à incorporer. M'interrogeant sur ce processus de précarisation matérielle et positionnelle des femmes migrant seules, la deuxième partie étudie le parcours des femmes originaires d'Antananarivo migrant dans le cadre d'un mariage par correspondance en France. Mon objectif est de vérifier si, tout comme l'exode vers le monde urbain, leur migration vers les pays occidentaux concourt aussi à les maintenir dans des positions oppressives vis-à-vis des rapports conjugaux et économiques. L'observation de la migration internationale des femmes malgaches se fait au travers d'un processus temporel régi en faits circonstanciés menant à la décision de départ. En France deux figures processuelles opposées différencient leur positionnement face à la domination masculine. D'un côté, des femmes ont mis un terme à leur mariage transnational et se sont engagées dans un parcours migratoire solitaire. Séparées, sans ressources ni soutien familial, elles sont prises dans des processus de précarisation jusqu'alors méconnus. Leur itinéraire migratoire est fortement imprégné de multiples vulnérabilités liées à leurs conditions d'installation. D'un autre côté, des femmes se sont maintenues en couple en tentant de conserver le statut d'épouse. Leur parcours en France s'inscrit dans le cadre conjugal parsemé de multiples épreuves. A Antananarivo comme en France, les deux types de migration féminine malgache illustrent l'ensemble de difficultés auxquelles les femmes doivent faire face pour échapper aux rapports oppressives de genre et de classe. Si la migration est conçue dans le but de trouver des ressources économiques et affectives, on s'aperçoit que c'est la dépossession des avoirs de départ qui dissout rapidement les tentatives de sécurisation. Dans un premier temps, leur parcours consiste à lutter pour la survie. Le cadre étant difficilement réalisable, celui des migrantes venues à Antananarivo se resserre autour de cette survie. Pour les femmes migrant en France, lorsque la subsistance est préservée, elles doivent lutter contre les tensions générées par les contraintes de leur position déclassée à travers de multiples stratégies de négociations et de bricolages. Dans chacune des migrations féminines, la quête affective passe par une anticipation idéalisée des relations conjugales, mais qui est très vite contrecarrée par la mise à l'épreuve des violences masculines instituées par ce cadre
The subject of my thesis is the analysis of the processes that tend to keep Malagasy women in subordination and dependence on men when they migrate in order to improve their lot and that of their family. My intention is to report on the experiences encountered during their migration in order to understand what hinders their quest for security and keeps them in material and positional precariousness compared of men. Beyond the differences in socio-economic positions of origin and the type of migration carried out by these women, the oppressions they suffer remain similar. The circumstances for escaping depend on the security possibilities offered by the place of migration.The first part concerns the rural exodus which led women to settle in the poor neighborhoods of Antananarivo (the capital of Madagascar). The exodus whether initiated by a family survival strategy or by an individual choice made by themselves, does not result in securing their living conditions. Family and personal hardships demonstrate the vulnerability of life courses when women are detached from the family support system. The impossibility of returning to the village, combined with the difficulties of finding resources define their borderline situation between a peasantry that has rejected them and an urban world that is difficult to incorporate. Questioning myself on this process of material and positional precariousness of women migrating alone, the second part studies the path of women from Antananarivo migrating within the framework of a mail-order marriage in France. My objective is to verify whether, like the exodus to the urban world, their migration to Western countries also contributes to keeping them in oppressive positions vis-à-vis marital and economic relations. The observation of the international migration of Malagasy women is done through a temporal process governed by detailed facts leading to the decision to leave.In France, two opposing procedural figures differentiate their positioning in the face of male domination. On the one hand, women have ended their transnational marriage and embarked on a solitary migration journey. Separated, without resources or family support in France, they are caught up in processes of precariousness hitherto unknown. Their migratory route is strongly impregnated with multiple vulnerabilities linked to their conditions of installation. On the other hand, women have maintained themselves as a couple by trying to maintain the status of wife. Their journey in France is part of the marital framework strewn with multiple ordeals. In Antananarivo as in France, the two types of Malagasy female migration illustrate the set of difficulties that women must face in order to escape oppressive gender and class relations. If migration is designed with the aim of finding economic and affective resources, we see that it is the dispossession of initial assets that quickly dissolves attempts to secure it. At first, their journey is to fight for survival. The framework being difficult to achieve, that of the migrant women who have come to Antananarivo is tightened around this survival. For women migrating to France, when subsistence is preserved, they must fight against the tensions generated by the constraints of their downgraded position through multiple strategies of negotiation and DIY. In each of the female migrations, the affective quest passes through an idealized anticipation of conjugal relations, but which is very quickly thwarted by the testing of male violence instituted by this framework

The water supply in rural areas in developing countries has attracted the interest of the international development community since over two decades. However, the problems of the rural water supply sector seem not to have changed: the sector still remains relegated to the second place in public investment programmes in most developing countries; still over half of the rural application do not have access to safe water; broken down or badly-functioning water supplies litter the rural landscape of many developing countries. Different alternatives have been promoted with a view to extending rural water supply coverage, and more importantly to ensuring the sustainability of the completed projects. A common denominator in these alternatives is the search for the participation of the projects' intended beneficiaries. The participatory approach has become an overriding principle of the development policy of the rural water supply sector. The economic climate which has reduced the ability, or has, in reality, rendered national governments unable to provide or subsidise water supply services to rural areas also underlies the promotion of the approach. In such a situation, the consideration of the desirability and applicability of the approach in particular contexts, tends to be neglected. The case study suggests that participation is no panacea. More important is the contextual conditions of the application of the participatory approach. A project cannot constitute a framework for promoting meaningful participation. The main concern of the implementing agency involved is bound to get a water supply project completed. Participation is seen as a means to achieve this objective; the project's intended beneficiaries are used as input.

In order to ensure its livelihoods, as many other all over the world, the population of Madagascar is increasing the pressure on resources, and in particular, on local biomass. This study examines how institutions are acting in the governance of biomass regarding to its potential impacts on global health. Thirty semi-structured interviews and twelve focus groups involving farmers and local institutional leaders were conducted in two disparate Communes near the capital Antananarivo. The purpose of these discussions was to gather information linking global health to the life of agrarian communities. As achievement of the methodological deployment, a mapping of institutions was set, showing the coexistence in the Malagasy highlands of traditional institutions: the household (ankohonana), the community (fokonolona) and the state (fanjakana), and new ones: the decentralised collectivity or Commune, religious communities and private enterprises or firms. Households, even though as mostly agrarian, are the most active in the production, consumption and transfer of biomass. However, their decision-making aptitude on biomass governance can be influenced by the authority of the state as a provider of public policies or by the holders of financial means as firms that favour certain productions over others. The activities of the interacting institutions maintain the power relations between them more than they preserve the regenerative capacity of biomass, the main source of well-being for agrarian societies.