Quality of Antenatal Care and Obstetrical Coverage in Rural Burkina Faso.

Improving maternal health is one of the Millennium Development Goals of the United Nations. Despite the efforts to promote maternal and neonatal care to achieve this goal, the use of delivery care remains below expectations in Burkina Faso. This situation raises the question of the quality of care offered in maternity wards. The aim of this study was to identify primary healthcare facility and antenatal care characteristics predictive of an assisted delivery in rural Burkina Faso. A cross-sectional study was carried out in Gnagna province (North-East Burkina Faso) in November 2003. The operational capacities of health facilities were assessed, and a non-participating observation of the antenatal care (ANC) procedure was undertaken to evaluate their quality. Scores were established to summarize the information gathered. The rate of professional childbirth (obstetrical coverage) was derived from the number of childbirths registered in the health facility compared to the size of the population. The established scores were related to the obstetrical coverage using non-parametric tests (Kendall). In total, 17 health facilities were visited, and 81 antenatal consultations were observed. Insufficiencies were observed at all steps of ANC (mean total score for the quality of ANC=10.3±3.0, ranging from 6 to 16, out of a maximum of 20). Health facilities are poorly equipped, and the availability of qualified staff remained low (mean total score for the provision of care was 22.9±4.2, ranging from 14 to 33). However, these scores were not significantly related to the rate of professional childbirth (tau Kendall=0.27: p=0.14 and 0.01, p=0.93 respectively). The ability of the primary health centres to provide good antenatal care remains low in rural Burkina Faso. The key factors involved in the limited use of professional childbirth relating to maternal health services may be the quality of ANC.

Evaluation des taux d'infection par le VIH1 a Libreville; Gabon; en 1991 : evolution depuis 1986

Les auteurs rapportent les resultats d'une enquete de seroprevalence VIH1 effectuee en mars 1991 par le sondage en grappes dans la population generale de Libreville; Gabon. En populations standardisees; le taux de seroprevalence est de 2;8 pour cent; il etait de 1;6 pour cent en 1986 et de 2;0 pour cent en 1989. D'un point de vue methodologique; au lieu de realiser un passage transversal unique comme lors des enquetes precedentes; les enqueteurs sont repasses pour inclure dans l'echantillon les personnes absentes au premier passage. Si les resultats sont identiques pour le VIH1; les taux de serologie treponomique sont significativement superieurs chez les personnes absentes. Ceci suggere une possibilite de biais dans la representativite des echantillons realises pour ce type d'etude par passage transversal unique