Quality cesarean delivery in Ouagadougou, Burkina Faso: A comprehensive approach
Received 9 January 2008; received in revised form 8 July 2008; accepted 20 August 2008. published online 10 November 2008.
Abstract
Objective
To assess the effects of a comprehensive intervention (staff training, equipment, internal clinical audits, cost sharing system, patients–providers meetings) in improving cesarean delivery access and quality in an urban district of Burkina Faso.
Methods
We conducted a before-after study in the health district sector 30 in Ouagadougou between 2003 and 2006. We measured cesarean delivery quality (accessibility, diagnosis, procedure, postoperative follow-up) and maternal and neonatal health in 1371 sections.
Results
The number of cesarean deliveries performed increased each year, from 42 in 2003 to 630 in 2006. This increase happened without increase in maternal and perinatal post-cesarean mortality (respectively 1.1% and 3.6% in 2006). The cesarean delivery rate for women of the district increased from 1.9% to 3.3% of expected births between 2003 and 2005.
Conclusion
To improve access to quality cesarean delivery, we have shown that it was necessary to have a systemic approach combining technical, operational, sociocultural, and political factors.
ABSTRACT