Césarienne à Lubumbashi, République Démocratique du Congo II: facteurs de risque de mortalité maternelle et périnatale

Kinenkinda, Xavier; Mukuku, Olivier; Chenge, Faustin; Kakudji, Prosper; Banzulu, Peter; Kakoma, Jean-Baptiste; Kizonde, Justin

doi:10.11604/pamj.2017.26.208.12148

Cited by 9 publications

(10 citation statements)

References 29 publications

(29 reference statements)

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“…Nonetheless, wealth quintile-specific analysis further indicated that the poorest had the highest odds (OR,4.4) of cesarean-related neonatal deaths even though they had the lowest cesarean delivery rates. These findings partly concur with previous health facility-based studies across many low-and middle-income settings that suggest that cesarean delivery (CD), both emergency and planned, has had net poor perinatal and neonatal outcomes [5,[22][23][24][25][26][27][28] This study is perhaps the first of its kind to examine the influence of socioeconomic factors on cesarean delivery and neonatal survival outcome resulting from C-section at national levels in Kenya and Tanzania. C-section as an increasingly preferred mode of birth does not guarantee better neonatal outcomes in East Africa.…”

Section: Discussionsupporting

confidence: 88%

“…Elective CD has been associated with sepsis and respiratory problems, which are major causes of neonatal deaths globally [19]. While cesarean delivery has prevented many adverse pregnancy outcomes, the quality and conditions under which some procedures (both elective and emergency) are executed in many low-resourced settings have also resulted in many morbidities [20,21] and preventable mortalities [5,[22][23][24][25][26][27][28]. The trade-offs between morbidities and benefits are generally unclear but also costly for weak health-care systems [29,30].…”

Section: Introductionmentioning

confidence: 99%

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Cesarean delivery and associated socioeconomic factors and neonatal survival outcome in Kenya and Tanzania: analysis of national survey data

Arunda

Agardh

Asamoah

2020

Global Health Action

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Background: The increasing trends in cesarean delivery are globally acknowledged. However, in many low-resource countries, socioeconomic disparities have created a pattern of underuse and overuse among lower and higher socioeconomic groups. The impact of rising cesarean delivery rates on neonatal survival is also unclear. Objective: To examine cesarean delivery and its associated socioeconomic patterns and neonatal survival outcome in Kenya and Tanzania. Methods: We employed binary logistic regression to analyze cross-sectional demographic and health survey data on neonates born in health facilities in Kenya (2014) and Tanzania (2016). Results: Cesarean delivery rates ranged from 5% among uneducated, rural Tanzanian women to 26% among educated urban women in Kenya to 37.5% among managers in urban Tanzania. Overall findings indicated higher odds of cesarean delivery among mothers from richest households, adjusted odds ratio (aOR) 1.4 (95% CI 1.2-1.8), those insured, aOR 1.6 (95% CI 1.3-1.9), highly educated, aOR 1.6 (95% CI 1.2-2.0) and managers aOR 1.7 (95% CI 1.3-2.2), compared to middle class, no insurance, primary education and unemployed, respectively. Overall, compared to normal births and while adjusting for maternal risk factors, cesarean delivery was significantly associated with neonatal mortality in Kenya and Tanzania, overall aOR 1.7 (95% CI 1.2-2.7). However, statistical significance ceased when fetal risk factors and number of antenatal care visits were further controlled for, aOR 1.6 (95% CI 0.9-2.6). Conclusion: Disproportionate access to cesarean delivery has widened in Kenya and Tanzania. Higher risks of cesarean-related neonatal deaths exist. Medically indicated or not, the safety and/or choice of cesarean delivery is best addressed on individual basis at the health-facility level. However, policy initiatives to eliminate incentives, improve equitable access and accountability to reduce unnecessary cesarean deliveries through well-informed decisions are needed. Efforts to prevent unintended pregnancies among adolescents as well as training of health workers and continuous research to improve neonatal outcomes are vital.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Cesarean delivery and associated socioeconomic factors and neonatal survival outcome in Kenya and Tanzania: analysis of national survey data

Arunda

Agardh

Asamoah

2020

Global Health Action

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“…The distribution of included articles by country was as follows:, Algeria [60], Benin [78], Burkina Faso [122,143], Cameroon [99,133], Democratic Republic of Congo [55,82], Egypt [105], Eritrea [102], Ethiopia [57,62,71,72,74,86,130,131], Ghana [49,52,53,58,69,141], Guinea-Bissau [76], Kenya [63,91,110,123,142,145], Madagascar [79], Malawi [80,83,100,126,140], Morocco [44], Mozambique [59], Nigeria [42,43,45,47,48,54,56,65,67,89,…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Individual, health facility and wider health system factors contributing to maternal deaths in Africa: A scoping review

Muriithi

Banke-Thomas

Gakuo

et al. 2022

PLOS Glob Public Health

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The number of women dying during pregnancy and after childbirth remains unacceptably high, with African countries showing the slowest decline. The leading causes of maternal deaths in Africa are preventable direct obstetric causes such as haemorrhage, infection, hypertension, unsafe abortion, and obstructed labour. There is an information gap on factors contributing to maternal deaths in Africa. Our objective was to identify these contributing factors and assess the frequency of their reporting in published literature. We followed the Arksey and O’Malley methodological framework for scoping reviews. We searched six electronic bibliographic databases: MEDLINE, SCOPUS, African Index Medicus, African Journals Online (AJOL), French humanities and social sciences databases, and Web of Science. We included articles published between 1987 and 2021 without language restriction. Our conceptual framework was informed by a combination of the socio-ecological model, the three delays conceptual framework for analysing the determinants of maternal mortality and the signal functions of emergency obstetric care. We included 104 articles from 27 African countries. The most frequently reported contributory factors by level were: (1) Individual—level: Delay in deciding to seek help and in recognition of danger signs (37.5% of articles), (2) Health facility—level: Suboptimal service delivery relating to triage, monitoring, and referral (80.8% of articles) and (3) Wider health system—level: Transport to and between health facilities (84.6% of articles). Our findings indicate that health facility—level factors were the most frequently reported contributing factors to maternal deaths in Africa. There is a lack of data from some African countries, especially those countries with armed conflict currently or in the recent past. Information gaps exist in the following areas: Statistical significance of each contributing factor and whether contributing factors alone adequately explain the variations in maternal mortality ratios (MMR) seen between countries and at sub-national levels.

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“…Définition des variables: pour la parité, nous avons défini comme pauci-pare (parité 1 à 2), multipare (parité 3 à 4) et grande multipare (parité >4) [ 22 ]. Le niveau socio-économique était classé comme bas (absence de salaire ou de source de revenus clairement définie ou ne disposant ni de téléphone ni de trousse d´accouchement), moyen (avec ou sans salaire mais disposant d´un téléphone fonctionnel et d´une trousse d´accouchement) et élevé (salaire disponible avec avantages liés à la fonction, disposant d´un téléphone fonctionnel et d´une trousse d´accouchement) [ 23 ].…”

Section: Méthodesunclassified

“…Le niveau socio-économique était classé comme bas (absence de salaire ou de source de revenus clairement définie ou ne disposant ni de téléphone ni de trousse d´accouchement), moyen (avec ou sans salaire mais disposant d´un téléphone fonctionnel et d´une trousse d´accouchement) et élevé (salaire disponible avec avantages liés à la fonction, disposant d´un téléphone fonctionnel et d´une trousse d´accouchement) [ 23 ]. Le statut marital était classé comme marié (une femme qui vit en union) et célibataire (celle qui vit seule) [ 22 ]. Le niveau d´études était défini comme primaire (études primaires avec ou sans certificat), secondaire (études secondaires ou diplôme de fin d´études secondaires) et supérieur (études universitaires avec ou sans diplôme) [ 16 , 23 ].…”

Section: Méthodesunclassified

Dépistage néonatal de la drépanocytose au cours de la pandémie au COVID-19 à Kisangani, en République Démocratique du Congo

Kasai¹,

Opara²,

Agasa³

et al. 2020

Pan Afr Med J

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Introduction l´implémentation du dépistage néonatal de la drépanocytose pendant la pandémie de coronavirus (COVID-19) représente un défi majeur en République Démocratique du Congo (RDC). La présente étude vise à déterminer si des facteurs socio-économiques sont associés à l´acceptabilité du dépistage néonatal de la drépanocytose pendant la COVID-19 à Kisangani, en RDC. Méthodes étude observationnelle conduite dans les maternités de Kisangani du 21 mars au 30 juin 2020 chez les mères sensibilisées au dépistage néonatal de la drépanocytose de leurs nouveau-nés à l´hemotypeSC TM (HT401RUO-USA). Les données recueillies étaient la parité, le niveau d´étude, l´âge, le niveau socio-économique, la profession, la notion de sensibilisation et le motif du refus du dépistage. Résultats sur 55,5% (273/492) des mères sensibilisées, 107 (39,19 %) ont accepté et 166 (60,80 %) ont refusé le dépistage néonatal de la drépanocytose chez leur nouveau-né. Les motifs du refus étaient l´absence d´information (67,5%; IC 95% [59,8-74,5]), le manque d´argent dû au confinement (66,3%; IC 95% [58,5-73,4]), la prise de sang pour tentative du vaccin anti-COVID-19 (63,2%; IC 95% = [55,4-70,6]). Les facteurs associés à l´acceptabilité du dépistage étaient l´âge > 35 ans (p = 0,0009; ORa = 3,04; IC 95% = 1,57-5,87) et le bas niveau socio-économique (p = 0,0016; ORa = 2,29; IC à 95% = 1,37-3,85). Conclusion l´acceptabilité du dépistage néonatal de la drépanocytose pendant la COVID-19 reste faible à Kisangani. Le gouvernement devrait identifier les canaux de communication efficaces afin de promouvoir les initiatives dans le secteur de la Santé.

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Césarienne à Lubumbashi, République Démocratique du Congo II: facteurs de risque de mortalité maternelle et périnatale

Cited by 9 publications

References 29 publications

Cesarean delivery and associated socioeconomic factors and neonatal survival outcome in Kenya and Tanzania: analysis of national survey data

Cesarean delivery and associated socioeconomic factors and neonatal survival outcome in Kenya and Tanzania: analysis of national survey data

Individual, health facility and wider health system factors contributing to maternal deaths in Africa: A scoping review

Dépistage néonatal de la drépanocytose au cours de la pandémie au COVID-19 à Kisangani, en République Démocratique du Congo

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