Article (Scientific journals)
Références et issues des accouchements au Kivu, République démocratiquedu Congo
Mugisho, E; Dramaix, M; Porignon, Denis et al.
2003In Revue d'Épidémiologie et de Santé Publique, 51 (2), p. 237-244
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Abstract :
[en] BACKGROUND: The process of referral between the first and the second level of the health system in the Democratic Republic of Congo is poorly understood. This report intends to study the association between the referral and the hospital perinatal outcomes. METHODS: Delivery outcomes in a retrospective cohort of 1162 women admitted between June 95 and May 96, in two referral hospitals in Kivu were analyzed according to the referral status and the women's characteristics. RESULTS: Forty-three percent (n=492)of women admitted, corresponding to 2.3% of expected pregnant women, were referred. Referred women had higher risks of obstetrical complications (OR=2.0; CI95%: 1.3-3.1) and intervention (OR=1.5; CI95%: 1.0-2.3) and similar risks of low birth weight and perinatal mortality. Women with complications during the antenatal period had a double risk of intervention and perinatal mortality. The risk of obstetrical intervention was lower when women had attended 2 visits (OR=0.5; CI95%: 0.3-0.8); the risk of low birth weight was lowest only for mothers who had attended one visit (OR=0.5; CI95%: 0.3-0.9). Distance > or =90 minutes walking from home to hospital raised the risk of obstetrical complication (OR=1.7; CI95%: 1.1-2.5), the risk of obstetrical intervention (OR=1.5; CI95%: 1.0-2.1), and the risk of perinatal mortality (OR=1.6; CI95%: 1.0-2.7). Late admission raised the risk of perinatal mortality (OR=1.8; CI95%: 1.2-2.9) and lowered the risk of obstetrical complication (OR=0.7; CI95%: 0.5-1.0). Part payment of care was associated with higher risks of low birth weight (OR=1.9; CI95%: 1.3-2.9), perinatal mortality (OR=2.2; CI95%: 1.4-3.5) and obstetrical intervention (OR=2.4; CI95%: 1.7-3.4). CONCLUSION: These results suggest a deficit of referred cases considering that 15% of pregnant women in the area covered by the referral hospitals should have been referred. They confirm the negative influence of economic and geographic constraints on the delivery outcomes. They point out the relevance of making reorganization of the referral system a priority.
Disciplines :
General & internal medicine
Author, co-author :
Mugisho, E
Dramaix, M
Porignon, Denis  ;  Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique : aspects spécifiques
Musubao, E
Hennart, P
Buekens, P
Language :
French
Title :
Références et issues des accouchements au Kivu, République démocratiquedu Congo
Publication date :
2003
Journal title :
Revue d'Épidémiologie et de Santé Publique
ISSN :
0398-7620
eISSN :
1773-0627
Publisher :
Elsevier Masson, Issy-les-Moulineaux, France
Volume :
51
Issue :
2
Pages :
237-244
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
© 2003 Elsevier Masson SAS. Tous droits réservés
Available on ORBi :
since 04 February 2015

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