Maternal Deaths Audit in Four Benin Referral Hospitals: Quality Of Emergency Care, Causes and Contributing Factors

Saizonou Jacques, Ouendo Edgard-Marius, Dujardin Bruno

Abstract

Objective. Analyse evolution of maternal deaths and quality of emergency obstetric care provided to the women admitted in four Benin referral maternities thus causes and reasons of deficiencies contributing to maternal death.

A transversal retrospective study was conducted in two stage: evolution of maternal death ratio added to living births was analysed from 1994 to 2003, followed by extensive analysis of maternal death in 2003. Different hospital data recording and individual interviews were the main sources of data collecting.

Maternal mortality ratio in hospitals didn't evolve since 10 years. The poor quality of care was noticed in 59 % of cases. Direct obstetric causes were prevailing in 74% of cases and the leading specific causes were haemorrhage (32,2%), infection (31,6%). Deficiencies in health system, medicals errors in treatment and monitoring, patients' financial unavailability and inadequate management of septic abortions were the main contributing factors. Maternal deaths continue to happen unacceptably in Benin. The drastic solutions have to be taken at all levels to improve maternal health. (Afr J Reprod Health 2006; 10[3]:28-40)

 

Keywords: Audit, maternal death, quality, causes, dysfunctions, determinants, Benin

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References

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Sahel A, De Brouwere V, Lardi M, Van Lerberghe N, Ronsmans C, Filippi V. Obstetric disasters narrowly avoided: near misses in Moroccan hospitals. Cahier Santé 2001; 111: 229-35

Mahler H. The Safe Motherhood Initiative: a call to action. Lancet 1987: 668-670

Graham WJ, Bell JS & Bullough CH. Can skilled attendance at delivery reduce maternal mortality in developing countries? Studies in Health Services Organization and Policy 2001; 17: 97-130.

Ouédraogo C, Bouvier-Colle MH. Maternal mortality in West Africa: how, how and why? J Gynecol Obstet Biol Reprod 2002; 31: 80-89

Bouvier-Colle MH, Ouédraogo C, Dumont A, Vangeenderhuysen, Salanave B, Decam C and the MOMA group. Maternal mortality in West Africa. Acta Obstet Gynecol Scand 2001; 80: 113-119

Fawcus S, Mbizvo M, Lindmark G, Nystrom L. A community-based investigation of preventable factors for maternal mortality in Zimbabwe. Studies in Family Planning 1996; 27: 319-327

Kodio B, Traoré S. Assesment of maternal mortality and late maternal mortality among pregnant women in Bamako, Mali. Br J Obstet Gynaecol 1999; 106: 60-5

Haddad S & Foumier P. Quality, cost and use of health services in developping countries. A longitudinal study in Zaire. Social Science and Medicine 1995; 40: 743-53

Haddad 1998, Fournier P, Machouf N, Yatara F. What does quality mean to lay people? Community perceptions of primary care services in Guinea. Soc Sci Med 1998; 47: 381-94.

Benign. Minister of Public Health. Yearbook of Health Statistics 2003. DPP / SSDRO; 2004.

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WHO International Staistical Classification of Diseases and Related Health Problems, 10th revision vol. 1, Geneva: WHO; 1992.

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WHO. "Report on Health in the World: Changing the Course of History". Geneva: WHO, 2004.

Saizonou J, Fourn L, Leynen F, Martiny P, Dujardin B. A comparative study of the quality of the management of "beautiful escapees" in reference maternities in Benin. Arch Public Health 2005, 63, 85-105.

Family health International Network. Better care in the postpartum saves lives. [See 30.03.05]. Available from: http://www.fhi.org/en/networkf/fv17.4/nf 1744.html.

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