Health and Migration Trajectories of Housekeepers in Bamako

NCT05472051 | Completed

• 1 other identifier: ANRS 0005s
• Study Type: observational
• Target: 644
• Locations: 1 country
• Sites: 1

Brief Summary

In Mali, migration from rural zones is a cultural phenomenon existing since 1970. During the dry season (9 months), an important number of young women leave their villages and migrate towards urban zones to seek for a job. In Bamako, the estimated number of housekeepers is 100 000 coming from rural regions and aged between 11 and 19 years. The current healthcare offer seems to be non-adapted to their particularities. This is a community-based research constructed on the basis of the activities of two NGOs in Mali: ADDAD (association for the defense of the rights of Housekeepers and domestic helpers ) and ARCAD Santé PLUS (the main NGO for healthcare access for HIV, hepatitis, and sexual health services). The research is conducted by the SanteRCom team in the UMR1252 SESSTIM research unit. The main objective of this observational study is to study the knowledge, beliefs, behaviors and practices in terms of health in general, and sexual health in particular; and to assess the acceptability of an offer of community-based prevention and health services provided by ARCAD Santé PLUS integrated in the activities of ADDAD. The integrating of community-based healthcare offer in a familiar and reassuring framework, such as that of ADDAD, should promote access to health services among housekeepers. The research is organized in 3 stages:

1. 1.Preliminary qualitative survey based on focus group discussions. Allowing the identification of the housekeepers' needs in terms of prevention and healthcare services; and the behavioral particularities of the housekeepers community. It is planned to conduct 7 focus groups including between 42 and 56 housekeepers.
2. 2.Communication and awareness campaigns in the regions of origin of housekeepers. Campaigns will be constructed on the basis of the results obtained from the preliminary qualitative survey.
3. 3.Communication and awareness campaigns in Bamako; community-based activities for housekeepers will be organized 3 times per week during 5 months by the NGO ADDAD. Activities will include the community-based offer of prevention and healthcare services provided by the NGO ARCAD Santé PLUS, i.e. the novelty in the ADDAD's activities. A quantitative and qualitative surveys will be conducted over 5 months with participants recruited during the community-based activities. It is expected to enroll at least 1134 housekeepers, and to conduct a maximum of 25 individual interviews with selected housekeepers.

Conditions

HIV Infections; Hepatitis B; Hepatitis C; Tuberculosis; STIs; Sex Behavior

Keywords

Housekeepers; Young girls; Mali; Accès to healthcare; Community-based services

Outcome Measures

Primary Outcomes (5)

• Acceptability of the community-based offer of healthcare services

  Percentage of housekeepers attending the community-based healthcare services during the ADDAD's activities (among the total number of housekeepers attending the ADDAD's activities)

  18 month after the start of the study

• Prevalence of infectious diseases among housekeepers attending the community-based healthcare services and accepting screening

  Prevalence of infectious diseases among housekeepers attending the community-based healthcare services and accepting screening: Percentage of HIV positive Percentage of HBV positive Percentage of HCV positive Percentage of TB POSITIVE Percentage of genital infectious diseases

  18 month after the start of the study

• Pregnancy

  Number of positive pregnancy tests among housekeepers accepting screening

  18 month after the start of the study

• HBV Vaccin

  Number of housekeepers accepting HBV vaccine among those negative to both HBV and HCV

  18 month after the start of the study

• Mental health

  Prevalence of mental disorders such as depression, anxiety, insomnia, post-traumatic stress

  18 month after the start of the study

Study Arms (1)

Young girls housekeepers

Malian young girls migrating from rural areas towards Bamako to seek for a job as housekeepers. Include young girls aged at least 12 years.

Other: Community-based healthcare offer provided by an the ARCAD Santé PLUS NGO and integrated into the activities of the ADDAD NGO

Interventions

Community-based healthcare offer provided by an the ARCAD Santé PLUS NGO and integrated into the activities of the ADDAD NGO OTHER

In the framework of the current activities of the ARCAD Santé PLUS a team formed by a doctor, a nurse and laboratory assistant will provide prevention and medical activities during the community-based activities organized by the housekeepers ADDAD NGO. The medical consultation will propose: * HIV screening, including pre- and post- counseling * Hepatitis B and hepatitis C screening, including pré- and post- counseling. The HBV vaccine will be proposed to housekeepers with negative results to both HBV and HCV testing * Tuberculosis screening will be proposed to housekeepers with symptoms suggesting the possibility of TB * For housekeepers sexually active, the medical team will propose a gynecological test in order to screen for genital infections. Furthermore, a pregnancy test will be proposed. Medicines for current diseases (headache, diarrhea, etc. will be provided by the medical staff).

Young girls housekeepers

Eligibility Criteria

• Age: 12 Years+
• Gender Eligibility Details: Young girls working in Bamako as housekeepers (not self-representation)
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Young girls working in Bamako as Housekeepers being aged at least 12 years.

You may qualify if:

• Being a young girl and working in Bamako as housekeeper
• Speak one of the most current languages : Bambara, Dogon, French
• Being aged at least 12 years,
• To provide written consent. For minors (12 to 17 years old) the consent of a member of the ADDAD NGO as the legal responsible.

You may not qualify if:

• Minor housekeepers refusing the presence and signature of the ADDAD's member
• Housekeepers whose mental health would be judged (by the doctor) not appropriate to participate
• Housekeepers not able to understand and/or to sign the written consent

Sponsors & Collaborators

• ANRS, Emerging Infectious Diseases: lead

Study Sites (1)

ADDAD

Bamako, Niamakoro, Sièbougouni, Rue 173, Porte 146, Commune VI, Mali

Location

MeSH Terms

Conditions

HIV Infections; Hepatitis B; Hepatitis C; Tuberculosis; Sexually Transmitted Diseases; Sexual Behavior

Condition Hierarchy (Ancestors)

Blood-Borne Infections; Communicable Diseases; Infections; Sexually Transmitted Diseases, Viral; Lentivirus Infections; Retroviridae Infections; RNA Virus Infections; Virus Diseases; Genital Diseases; Urogenital Diseases; Immunologic Deficiency Syndromes; Immune System Diseases; Hepadnaviridae Infections; DNA Virus Infections; Hepatitis, Viral, Human; Hepatitis; Liver Diseases; Digestive System Diseases; Flaviviridae Infections; Mycobacterium Infections; Actinomycetales Infections; Gram-Positive Bacterial Infections; Bacterial Infections; Bacterial Infections and Mycoses; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Behavior

Study Officials

• Luis Sagaon Teyssier, PhD

  UMR 1252 SESSTIM

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: ECOLOGIC OR COMMUNITY
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 13, 2021
• First Posted: July 25, 2022
• Study Start: February 28, 2022
• Primary Completion: June 22, 2023
• Study Completion: June 22, 2023
• Last Updated: March 12, 2024

Record last verified: 2024-03

Locations

MA (1)