ABSTRACT
Relevant epidemiological data are essential to improving management of maternal and child health services at district level. In public maternity hospitals of the health region of Monastir, Tunisia, a perinatal register has been established recording information related to pregnancy, childbirth and the condition of the newborn. During 1994, 7750 deliveries were registered, of which 46% took place in the university teaching hospital. Use of peripheral maternity hospitals varies according to the resources of the hospital; the university teaching hospital is highly attractive, especially for women from neighbouring districts. These findings raise the problem of the cost-effectiveness and relevance of opening new health facilities, particularly in times of economic crisis in the health care system