Health and Migration Trajectories of Housekeepers in Bamako

Completed

• Conditions: Tuberculosis; Sex Behavior; STIs; HIV Infections; Hepatitis C; Hepatitis B
• Interventions: Other: Community-based healthcare offer provided by an the ARCAD Santé PLUS NGO and integrated into the activities of the ADDAD NGO

• Registration Number: NCT05472051
• Lead Sponsor: ANRS, Emerging Infectious Diseases

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. 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. 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. 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.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2021-09-13
• Study Start: 2022-02-28
• Study First Submitted QC: 2022-07-21
• Study First Posted: 2022-07-25
• Primary Completion: 2023-06-22
• Study Completion: 2023-06-22
• Status Verified: 2024-03
• Last Update Submitted: 2024-03-11
• Last Update Posted: 2024-03-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 644

Inclusion Criteria

• 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.

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Exclusion Criteria

• 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

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Young girls housekeepers	Community-based healthcare offer provided by an the ARCAD Santé PLUS NGO and integrated into the activities of the ADDAD NGO	Malian young girls migrating from rural areas towards Bamako to seek for a job as housekeepers. Include young girls aged at least 12 years.

Primary Outcome Measures

Name	Time	Method
Pregnancy	18 month after the start of the study	Number of positive pregnancy tests among housekeepers accepting screening
HBV Vaccin	18 month after the start of the study	Number of housekeepers accepting HBV vaccine among those negative to both HBV and HCV
Mental health	18 month after the start of the study	Prevalence of mental disorders such as depression, anxiety, insomnia, post-traumatic stress
Acceptability of the community-based offer of healthcare services	18 month after the start of the study	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)
Prevalence of infectious diseases among housekeepers attending the community-based healthcare services and accepting screening	18 month after the start of the study	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

Trial Locations

Locations (1)

ADDAD; 🇲🇱 Bamako, Niamakoro, Sièbougouni, Rue 173, Porte 146, Mali