La qualité des soins obstétricaux en milieu rural malien : une étude exploratoire
To improve maternal health, it is essential to implement interventions that act on the intrapartum period, interventions that consist essentially in improving access to obstetric and neonatal emergency care (EmOC). Nevertheless, several countries that have turned to such interventions encounter significant challenges in their implementation and the high rates of maternal mortality persist.  This study aims to identify characteristics of structure and process in community health centers (CSCOM) where maternal deaths have occurred and to compare these characteristics with those of CSCOM where no maternal deaths have occurred. We opted for an exploratory comparative approach of CSCOM with patients with different outcomes and different human resources configuration. The study population corresponds to CSCOMs of Kayes region in which obstetric emergencies were managed. The main focus of this study is on human resources, availability of equipment, supply and medicine, and on the level of knowledge of health care providers in these health centers. Our data analysis revealed that there are large disparities in resources available at the CSCOM level. Yet, these resources are needed in order to adequately manage obstetric emergencies. Although none of the CSCOM characteristic can be associated with adverse outcomes, the accumulation of deficits in human and material resources as well as the lack of knowledge of certain categories of staff suggests that the poor quality of obstetric care may threaten the parturient survival.
Mali maternal mortality quality of healthcare EmOC