Espace populations sociétés (Dec 2006)
Attraction des services de soins de santé primaires et des centres de dépistage du VIH à Dakar (Sénégal)
Abstract
The large health service provision (traditional healing and modern medicine), the disparities in health insurance in case of illness and the large geographic and financial mobility, explain the interest to study the use of healthcare services in developing countries cities. In Senegal, within a geographical context that is constantly changing, the predictive models of use of healthcare services implemented by the Ministry of Heath have to be questioned regularly and adjusted to the complex reality. How can we ensure a population health coverage which complies with the Health Integrated Development Program (PDIS) objectives ? How can we make sure that women in emergency situation for risk childbirth are taken care of quickly ? The first part of this article shows the stakes of health planning. On the field, the persons in charge of healthcare centres and maternity wards have to situate themselves according to various spatial sectioning : the administrative scale of the urban district commune which is competent in the field of health, the scale of the health district, and the scale of the polarization area. The partition of the regional space carried out according to the Thiessen-Voronoi model makes it possible to question about the relevance of present sectioning in comparing the model areas with polarization areas set by the Ministry and the real attraction areas of the chosen maternity hospitals and health centres, in the second part of this article. In the last part, we showed that these inequalities exist as well for other non planned health services, which leads to the predominance of Dakar, as regards the volume of activities. The attraction areas of HIV anonymous voluntary screening centres of Dakar, Pikine and Guédiawaye raise question about the social network of patients and health professionals. In fine, this article from a study on Dakar urban areas, shows the intra-regional disparities in the field of reproductive health and situate itself in the dynamics of an improvement of the health facilities activity.
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