How has the free obstetric care policy impacted unmet obstetric need in a rural health district in Guinea?

Alexandre Delamou, Dominique Dubourg, Abdoul Habib Beavogui, Thérèse Delvaux, Jacques Seraphin Kolié, Thierno Hamidou Barry, Bienvenu Salim Camara, Mary Edginton, Sven Hinderaker, Vincent De Brouwere

Research output: Contribution to journalA1: Web of Science-article

4 Downloads (Pure)

Abstract

INTRODUCTION: In 2010, the Ministry of Health (MoH) of Guinea introduced a free emergency obstetric care policy in all the public health facilities of the country. This included antenatal checks, normal delivery and Caesarean section.

OBJECTIVE: This study aims at assessing the changes in coverage of obstetric care according to the Unmet Obstetric Need concept before (2008) and after (2012) the implementation of the free emergency obstetric care policy in a rural health district in Guinea.

METHODS: We carried out a descriptive cross-sectional study involving the retrospective review of routine programme data during the period April to June 2014.

RESULTS: No statistical difference was observed in women's sociodemographic characteristics and indications (absolute maternal indications versus non-absolute maternal indications) before and after the implementation of the policy. Compared to referrals from health centers of patients, direct admissions at hospital significantly increased from 49% to 66% between 2008 and 2012 (p = 0.001). In rural areas, this increase concerned all maternal complications regardless of their severity, while in urban areas it mainly affected very severe complications. Compared to 2008, there were significantly more Major Obstetric Interventions for Maternal Absolute Indications in 2012 (p < 0.001). Maternal deaths decreased between 2008 and 2012 from 1.5% to 1.1% while neonatal death increased from 12% in 2008 to 15% in 2012.

CONCLUSION: The implementation of the free obstetric care policy led to a significant decrease in unmet obstetric need between 2008 and 2012 in the health district of Kissidougou. However, more research is needed to allow comparisons with other health districts in the country and to analyse the trends.

Original languageEnglish
JournalPLoS ONE
Volume10
Issue number6
Pages (from-to)e0129162
Number of pages12
ISSN1932-6203
DOIs
Publication statusPublished - 2015

Fingerprint

Dive into the research topics of 'How has the free obstetric care policy impacted unmet obstetric need in a rural health district in Guinea?'. Together they form a unique fingerprint.

Cite this