Effets de l'observance des consultations prénatales et du recours aux accouchements assistés par des sage-femmes sur la mortalité néonatale au Bénin / NA

L'observancepar les gestantes des soins de santé maternelle réalisés par du personnel qualifié est connuepour réduire la probabilité de décès néonatal chez les nouveau-nés. Toutefois, le gain observé par rapport au recours à ces soinsest-il homogène quel que soit l'agent de santé qui réalise l'acte ?L'objectif de ce travail était d'étudier les effets de l'observance des consultations prénatales et du recours aux accouchements assistés par des agents qualifiés en général, et des sage-femmes en particulier, sur la mortalité néonatale au Bénin. Il s'est agi d'une étude transversale qui a consisté à réaliser des analyses secondaires à partir des bases de données du cinquième Enquête Démographique et de Santé (EDS-V) au Bénin. La population d'étude était constituée des enfants nés au cours des cinq années ayant précédé l'EDS-V. La variable dépendante était le décès (1=Oui vs 0=Non) des enquêtés avantle 28ème jour après la naissance. Pour chaque enfant inclus, il a été renseigné l'observance (ou non) des visites de soins prénataux ainsi que le type d'agents ayant procédé à ces actes. Le type de prestataire ayant assisté la mère lors de l'accouchement a également été renseigné. Une régression logistique multivariée a permis d'identifier les facteurs associés à la mortalité néonatale. Au total, 13044 enfants ont été inclus dans l'étude. Parmi ces derniers, 2,64% (IC95% = 2,32-3,01) étaient décédés avant le 28ème jour suivant la naissance. Le risque de décès néonatal était inférieur de 34% (ORa = 0,66 ; IC95% = 0,47-0,93) chez les enfants dont les mères avaient observé les consultations prénatales, réalisées par des sage-femmes, en comparaison aux enfants dont les mères n'avaient pas observé ces visites. Une relation significative n'a pas été observée entre le type de prestataire ayant assisté la mère lors de l'accouchement et la mortalité néonatale. L'étude souligne la nécessité de renforcer les stratégies visant une amélioration de l'offre et de la demande des visites de soins prénataux réalisées par des agents qualifiés en général, et des sage-femmes, en particulier.

Observance by pregnant women of maternal health care provided by qualified personnel is known to reduce the probability of neonatal death in newborns. However, is the gain observed in relation to the Page 53of70RASPVolume 5, Issue1use of this care homogeneous regardless of the health worker who performs the act? The objective of this work was to study the effects of compliance with prenatal consultations and the use of births attended by skilled attendantsin general, and midwives in particular, on neonatal mortality in Benin. This was a cross-sectional study that consisted of carrying out secondary analyzes from the databases of the fifth Demographic and Health Survey (DHS-V) in Benin. The study populationconsisted of children born during the five years preceding the EDS-V. The dependent variable was the death (1=Yes vs 0=No) of respondents before the 28th day after birth. For each child included, information was provided on compliance (or not) with prenatal care visits as well as the type of agents who carried out these acts. The type of provider who assisted the mother during childbirth was also provided. A multivariate logistic regression made it possible to identify the factors associated with neonatal mortality. A total of 13,044 children were included in the study. Of these, 2.64% (95% CI = 2.32-3.01) had died before the 28th day after birth. The risk of neonatal death was 34% lower (ORa = 0.66; 95% CI = 0.47-0.93) in children whose mothers had observed antenatal consultations, carried out by midwives, compared to children whose mothers had not observed these visits. A significant relationship was not observed between the type of provider who assisted the mother during childbirth and neonatal mortality.The study underscores the need to strengthen strategies aimed at improving the supply and demand for antenatal care visits by skilled workers in general, and midwives in particular.

Referral conditions for severe road traffic injuries and their influence on the occurrence of hospital deaths in Benin

Road traffic accidents are the leading cause of death by trauma. Delays in in first aid due, inter alia, to the long time to transfer traffic accident victims to hospital and the lack of pre-hospital emergency care, contribute to the increase in hospital mortality. This study aims to analyse the referral conditions for severe road traffic injuries and to assess their effect on the occurrence of hospital deaths in Benin. This is an analytical prospective cohort study conducted in road accident victims with a severe injury. Four groups of factors were studied: referral conditions, sociodemographic and victim-specific characteristics, factors related to the accident environment, and factors related to health services. A top-down binary stepwise logistic regression was the basis for the analyses. Nine point eight percent of severe trauma patients died after hospital admission (7.0-13.5). Associated factors were referral time greater than 1 hour (RR=5.7 [1.5-20.9]), transport to hospital by ambulance (RR=4.8 [1.3-17.3]) and by the police or fire department (RR=7.4 [1.8- 29.7]), not wearing protective equipment (RR=4.5 [1.4-15.0]), head injuries (RR=34.8 [8.7-139.6]), and no upper extremity injuries (RR=20.1 [2.3-177.1]). To reduce the risk of hospital death in severe road traffic injuries, it is important to ensure rapid and medicalized referral of severe trauma patients in Benin.

Evaluation of Feeding Practices in Children Aged 6- 23 Months in Southern Benin Rural Setting.

Aims: To assess feeding practices in children aged 6 to 23 months living in rural setting in southern Benin. Study Design: Population based cross-sectional and evaluative study. Place and Duration of Study: Southern Benin, from 1st April to 27th June, 2014. Methodology: Two hundred and fourty children (49.16% girls) aged 6-23 months were randomly selected by cluster sampling technique. Data on breastfeeding and, complementary feeding, food safety and socio-demographic characteristics were collected using a questionnaire. Feeding practices in children were assessed through World Health Organization indicators using predefined scores. Results: The median age of the children was 13 months and 61.65% children aged 12-23 months. Breastfeeding (82.08%), complementary feeding (37.08%) and food safety (15.94%) were adequate among the children. The overall quality of feeding practices was inadequate among children (73.90%) aged 6-23 months. Conclusion: Feeding practices was inadequate in children aged 6 to 23 months in southern Benin rural setting. Nutrition education interventions in mothers are needed to improve feeding practices in children aged 6 to 23 months living in southern Benin rural areas.