Quality cesarean delivery in Ouagadougou, Burkina Faso: A comprehensive approach

  • International Journal of Gynecology and Obstetrics, Volume 103, No. 3, Year 2008

listen audio

Study Justification:
The study aimed to assess the effects of a comprehensive intervention in improving the access and quality of cesarean delivery in Ouagadougou, Burkina Faso. The intervention included staff training, equipment provision, internal clinical audits, a cost-sharing system, and patients-providers meetings. The study was conducted between 2003 and 2006 in the health district sector 30 of Ouagadougou.
Highlights:
– The number of cesarean deliveries performed increased each year, from 42 in 2003 to 630 in 2006.
– The increase in cesarean deliveries occurred without an increase in maternal and perinatal post-cesarean mortality rates.
– The cesarean delivery rate for women in the district increased from 1.9% to 3.3% of expected births between 2003 and 2005.
Recommendations:
– Implement a comprehensive intervention approach that combines technical, operational, sociocultural, and political factors to improve access to quality cesarean delivery.
– Provide staff training to enhance skills and knowledge in performing cesarean deliveries.
– Ensure the availability of necessary equipment for safe and effective cesarean deliveries.
– Conduct regular internal clinical audits to monitor and improve the quality of cesarean deliveries.
– Establish a cost-sharing system to make cesarean deliveries more affordable for patients.
– Facilitate regular patients-providers meetings to enhance communication and address concerns.
Key Role Players:
– Healthcare providers: Obstetricians, gynecologists, midwives, nurses, anesthesiologists.
– Health administrators: District health officers, hospital administrators.
– Policy makers: Ministry of Health officials, government representatives.
– Community leaders: Traditional leaders, community health workers.
Cost Items for Planning Recommendations:
– Staff training programs and workshops.
– Procurement and maintenance of necessary equipment.
– Implementation of internal clinical audit systems.
– Development and maintenance of a cost-sharing system.
– Organization of patients-providers meetings.
– Communication and awareness campaigns.
Please note that the cost items provided are for budget planning purposes and may not reflect the actual costs involved.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study design is a before-after study, which is a relatively weak design in terms of establishing causality. However, the study did measure multiple aspects of cesarean delivery quality and maternal and neonatal health, which adds to the strength of the evidence. To improve the strength of the evidence, a randomized controlled trial or a quasi-experimental design with a control group could be considered. Additionally, including a larger sample size and longer follow-up period would provide more robust results.

Objective: To assess the effects of a comprehensive intervention (staff training, equipment, internal clinical audits, cost sharing system, patients-providers meetings) in improving cesarean delivery access and quality in an urban district of Burkina Faso. Methods: We conducted a before-after study in the health district sector 30 in Ouagadougou between 2003 and 2006. We measured cesarean delivery quality (accessibility, diagnosis, procedure, postoperative follow-up) and maternal and neonatal health in 1371 sections. Results: The number of cesarean deliveries performed increased each year, from 42 in 2003 to 630 in 2006. This increase happened without increase in maternal and perinatal post-cesarean mortality (respectively 1.1% and 3.6% in 2006). The cesarean delivery rate for women of the district increased from 1.9% to 3.3% of expected births between 2003 and 2005. Conclusion: To improve access to quality cesarean delivery, we have shown that it was necessary to have a systemic approach combining technical, operational, sociocultural, and political factors. © 2008 International Federation of Gynecology and Obstetrics.

N/A

The study titled “Quality cesarean delivery in Ouagadougou, Burkina Faso: A comprehensive approach” recommends implementing a comprehensive intervention to improve access to and quality of cesarean delivery in an urban district of Burkina Faso. The intervention includes several innovations:

1. Staff training: Providing training to healthcare providers involved in cesarean deliveries to improve their skills and knowledge.

2. Provision of necessary equipment: Ensuring that healthcare facilities have the necessary equipment and supplies for performing cesarean deliveries safely and effectively.

3. Internal clinical audits: Conducting regular audits within healthcare facilities to assess the quality of cesarean deliveries and identify areas for improvement.

4. Cost-sharing system: Implementing a system where the cost of cesarean deliveries is shared between the healthcare facility and the patient, making it more affordable and accessible.

5. Regular meetings between patients and providers: Facilitating communication and shared decision-making between patients and healthcare providers to ensure that the patient’s preferences and needs are considered during the cesarean delivery process.

These innovations were found to be effective in increasing the number of cesarean deliveries performed each year without an increase in maternal and perinatal post-cesarean mortality. The study concludes that a systemic approach combining technical, operational, sociocultural, and political factors is crucial for improving access to quality cesarean delivery.
AI Innovations Description
The recommendation from the study titled “Quality cesarean delivery in Ouagadougou, Burkina Faso: A comprehensive approach” is to implement a comprehensive intervention to improve access to and quality of cesarean delivery in an urban district of Burkina Faso. The intervention includes staff training, provision of necessary equipment, internal clinical audits, a cost-sharing system, and regular meetings between patients and providers.

The study found that the number of cesarean deliveries performed increased each year, from 42 in 2003 to 630 in 2006, without an increase in maternal and perinatal post-cesarean mortality. The cesarean delivery rate for women in the district also increased from 1.9% to 3.3% of expected births between 2003 and 2005.

The conclusion of the study highlights the importance of a systemic approach that combines technical, operational, sociocultural, and political factors to improve access to quality cesarean delivery.

Source: International Journal of Gynecology and Obstetrics, Volume 103, No. 3, Year 2008
AI Innovations Methodology
To simulate the impact of the main recommendations from the study on improving access to maternal health, a methodology could be developed as follows:

1. Identify the target population: Determine the specific urban district or region in Burkina Faso where the intervention will be implemented.

2. Baseline data collection: Gather data on the current state of cesarean delivery access and quality in the selected district. This includes information on the number of cesarean deliveries performed, maternal and perinatal mortality rates, and the cesarean delivery rate.

3. Develop the comprehensive intervention: Design and implement the recommended intervention, which includes staff training, provision of necessary equipment, internal clinical audits, a cost-sharing system, and regular meetings between patients and providers.

4. Implementation of the intervention: Execute the intervention in the selected district, ensuring that all components are implemented as planned.

5. Data collection during the intervention: Continuously collect data on the number of cesarean deliveries performed, maternal and perinatal mortality rates, and the cesarean delivery rate during the intervention period.

6. Analysis of data: Analyze the collected data to assess the impact of the intervention on cesarean delivery access and quality. Compare the data from before and after the intervention to identify any changes.

7. Evaluation of outcomes: Evaluate the outcomes of the intervention, including any improvements in cesarean delivery access, quality, and maternal and perinatal health outcomes.

8. Dissemination of findings: Share the results of the simulation with relevant stakeholders, including healthcare providers, policymakers, and the community, to raise awareness and promote further action.

By following this methodology, it will be possible to simulate the impact of the recommended intervention on improving access to maternal health in the selected district in Burkina Faso.


Statistics:
Citations: 13
Identifiers:
DOI: 10.1016/j.ijgo.2008.08.008
ISSN: 00207292
Research Areas:
Community Interventions, Health System and Policy, Maternal and Child Health
Study Countries:
Burkina Faso
Study Design:
Cohort Study, randomised-control-trial
Participants Gender:
Female
Share this:
Facebook
Twitter
LinkedIn
WhatsApp
Email