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Tous les pays du monde (2024)
No full textLa population mondiale compte 8,2 milliards d’habitants en 2024. Elle a été multipliée par plus de huit depuis deux siècles, et devrait continuer à croître jusqu’à atteindre peut-être 10 milliards à la fin du XXIe siècle. Comment est-elle répartie dans le monde ? Quels sont les pays dont la fécondité est la plus forte ? Ceux où l’espérance de vie est la plus élevée ? Tous les deux ans, Population & Sociétés publie un numéro intitulé « Tous les pays du monde » qui présente un tableau de la population mondiale s’appuyant sur les estimations et projections des Nations unies
End-of-life medical decisions in French overseas departments: results of a retrospective survey
No full textBackground
French laws governing end-of-life medical practices forbid euthanasia and affirm patients’ right to deep and continuous sedation until death. Cultural traditions and disparities in health care provision, as in overseas France, could limit the enforcement of such laws and modify end-of-life medical practices.
Aim
This research aims to describe end-of-life medical decisions in overseas France and to compare with those described in mainland France.
Methods
A retrospective study of a random sample of adult patients who died between March 2020 and February 2021 was conducted in four overseas French departments. Physicians who certified the deaths were asked to describe end-of-life care and medical decisions in a questionnaire.
Results
A total of 1815 deaths were analysed over 8730 questionnaires sent. Withholding treatments was the most frequent decision (41%), treatment for pain or symptoms was intensified for a third of patients, Deep and continuous sedation until death was implemented in 13.3% cases. The use of drugs to deliberately end life was mentioned in 1.3% deaths. At least one decision was made in 61.6% deaths. More decisions that may hasten death were made before predictable deaths. Intensification of pain and symptoms treatment was more frequent in 2022 than in 2010. Deep and continuous sedation was introduced by law in 2016 without prejudice to other decisions.
Conclusion
Physicians in overseas France have implemented recent changes in end-of-life laws, including deep and continuous sedation. Comparisons with 2010 mainland France survey show a better implementation of palliative medicine in 2022, with higher proportions of treatment withholding
Politique d’immigration, statut légal et fécondité des migrantes : le cas de Mayotte
No full textLa fécondité des immigrées est devenue dans certains contextes un sujet si sensible qu’il conduit parfois à des réformes constitutionnelles sur le droit de la nationalité, les femmes « sans papiers » étant soupçonnées d’instrumentaliser leur grossesse pour légitimer leur séjour dans leur pays d’accueil. En France, le territoire de Mayotte cristallise les débats en la matière. L’île, dont le statut est contesté par les Comores, a été progressivement intégrée à la France. Sa frontière avec les autres îles de l’archipel est aujourd’hui l’une des plus contrastées du monde sur le plan économique. Et, alors que la libre circulation a prévalu jusqu’en 1995, le contrôle de la frontière n’a cessé de se durcir depuis cette date. Mayotte offre donc un cas particulièrement intéressant pour étudier la relation entre politique migratoire, statut des migrants et fécondité. Dans ce document, sur la base d’une revue de littérature internationale, nous proposons un cadre d’analyse de ces relations. Nous exploitons par ailleurs l’enquête Migration-Famille-Vieillissement-Mayotte (MFVM, 2015-2016). Premier résultat : la proportion des femmes comoriennes « sans papiers » l’année de leur arrivée à Mayotte est historiquement élevée et elle a progressé au fil du renforcement de la frontière. Son incidence est telle (87% avant 1995, 97% entre 2011 et 2015), qu’il est impossible de comparer statistiquement les femmes selon leur statut légal à l’arrivée. Second résultat : la probabilité d’avoir un enfant suivant l’arrivée à Mayotte a évolué au fil du temps. Elle s’est accrue après l’instauration du visa Balladur qui a constitué un signal fort de mise en cause de la présence des Comoriens à Mayotte, et qui a pu conduire certaines femmes à adapter leur comportement de fécondité pour légitimer leur présence sur le territoire mahorais. Ce résultat rappelle que les comportements de fécondité peuvent répondre à des signaux institutionnels qui ne relèvent pas uniquement des politiques familiales. Après 1999, la probabilité d’avoir un enfant suivant l’arrivée s’est stabilisée, ce qui suggère que l’insécurité croissante vécue par les femmes en situation irrégulière du fait de l’accroissement des contrôles et des expulsions a pu limiter leur fécondité, comme cela a été observé dans d’autres contextes
The Demography of Crisis-Driven Outflows from Venezuela
No full textThe Venezuelan exodus represents the largest known displacement of people in recent Latin American history. The regional crisis caused by this mass Venezuelan migration drove the development of multiple interagency initiatives (such as the R4V platform) as well as academic attempts to keep track of outflow intensity. However, little is known about the age and gender composition of the emigrants since most existing literature to date has focused primarily on total volume and country-specific shares of migration outflows. This study examines the demographics of recent outflows from Venezuela, the chronology of associated changes, and the demographic implications for those remaining in the country. Official counts of Venezuelan-born populations compiled in seven main destinations are used to estimate annual outflows by age and gender from 2011 to 2021. Changes in the demographic composition of emigration are traced using parameters of the Rogers–Castro model, specifically the children-to-labor force dominance, and by decomposing the age contributions to the annual gross migraproduction rate. In the early phase of the crisis (2014–2017), emigration flows had high child dependency ratios. As the crisis entered its most acute phase (peaking in 2019), the mean age of migrants increased. Outward migration has resulted in the current Venezuelan population having 20 percent fewer women of reproductive age and 17.8 percent fewer individuals of working age. Consequently, the share of the population aged 60 or older has increased
Combined review of: Yaëlle Amsellem-Mainguy, 2021, Les filles du coin: Vivre et grandir en milieu rural [Local Girls: Living and Growing Up in a Rural Area], Les Presses de Sciences Po, and Sophie Orange, Fanny Renard, 2022, Des femmes qui tiennent la campagne [Women Who Keep the Countryside Going], La Dispute
No full textClémence Léobal, Ville noire, pays blanc: Habiter et lutter en Guyane française [Black City, White Country: Life and Struggle in French Guiana], 2022, Presses universitaires de Lyon, 210 pages
No full textCost‐effectiveness analysis of community‐led HIV self‐testing among key populations in Côte d'Ivoire, Mali, and Senegal
No full textIntroduction
HIV self‐testing (HIVST) is a promising strategy to improve diagnosis coverage among key populations (KP). The ATLAS (Auto Test VIH, Libre d'Accéder à la connaissance de son Statut) programme implemented HIVST in three West African countries, distributing over 380,000 kits up between 2019 and 2021, focussing on community‐led distribution by KP to their peers and subsequent secondary distribution to their partners and clients. We aim to evaluate the cost‐effectiveness of community‐led HIVST in Côte d'Ivoire, Mali and Senegal.
Methods
An HIV transmission dynamics model was adapted and calibrated to country‐specific epidemiological data and used to predict the impact of HIVST. We considered the distribution of HIVST among two KP—female sex workers (FSW), and men who have sex with men (MSM)—and their sexual partners and clients. We compared the cost‐effectiveness of two scenarios against a counterfactual without HIVST over a 20‐year horizon (2019–2039). The ATLAS‐only scenario mimicked the 2‐year implemented ATLAS programme, whereas the ATLAS‐scale‐up scenario achieved 95% coverage of HIVST distribution among FSW and MSM by 2025 onwards. The primary outcome is the number of disability‐adjusted life‐years (DALY) averted. Scenarios were compared using incremental cost‐effectiveness ratios (ICERs). Costing was performed using a healthcare provider's perspective. Costs were discounted at 4%, converted to 126 (210) per DALY averted in Côte d'Ivoire, 88– (210) in Senegal. Scaling‐up the ATLAS programme would also be cost‐effective, and substantial epidemiological impacts would be achieved. The ICERs for the scale‐up scenario were 122–224 (415) in Mali and 18–$128) in Senegal.
Conclusions
Both the implemented and the potential scale‐up of community‐led HIVST programmes in West Africa, where KP are important to overall transmission dynamics, have the potential to be highly cost‐effective, as compared to a scenario without HIVST. These findings support the scale‐up of community‐led HIVST to reach populations that otherwise may not access conventional testing services
Europe’s COVID-19 death toll in 2020 and 2021: stark regional differences
No full textEurope was hard-hit by the COVID-19 pandemic in 2020 and 2021. While its effects at national level are now well known, intranational differences have been less frequently investigated. Florian Bonnet, Pavel Grigoriev, Markus Sauerberg, Ina Alliger, Michael Mühlichen and Carlo-Giovanni Camarda fill this knowledge gap and show that considerable heterogeneity exists at regional level, even within the same country
