title: [Evaluation of a public health measure for the amelioration of birth safety in Martinique: 1977-1984].
abstract: A public health programme was instituted on the island of Martinique (in the Carribean archipelago) between 1977 and 1984. Its aim was to reduce the perinatal death rate in Martinique which was 25.7 per thousand in 1977 to the level found in France in the same year, namely 14 per thousand. The measures taken to improve the safety of deliveries included closing small maternity homes and improving the hospitals both public and private. The chief measure however, was to improve the availability of specialised antenatal care chiefly administered by midwives (free care consultations near the homes) for the poor and the less well educated women. The results showed that perinatal deaths in the island dropped to 14.9 per thousand in 1984. The major improvement was that women who had been attended by midwives had 10 per thousand perinatal deaths. This involved half the population of the island and the same results were found as to the wealthier and more educated women who were attended by private obstetricians. It was found to be possible to reduce the difference in the perinatal death rate between an African population in Martinique and an European population in European France.
authors.affiliation: Service de Gynécologie-Obstétrique, Hôpital Cochin, Clinique Universitaire Baudelocque, Paris.
authors.forename: E
authors.initials: E
authors.lastname: Papiernik
authors.forename: H
authors.initials: H
authors.lastname: Goujon
authors.forename: R
authors.initials: R
authors.lastname: Demeulemeester
authors.forename: R
authors.initials: R
authors.lastname: Mezin
mesh_terms: D001724:Birth Weight; D036861:Delivery, Obstetric / Q000592:standards; D005260:Female; D006302:Health Services Research; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008395:Martinique / Q000453:epidemiology; D008427:Maternal Health Services / Q000592:standards*; D009721:Nurse Midwives / Q000600:supply & distribution; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000592:standards*; D011635:Public Health Administration / Q000592:standards*; D012449:Safety; D000078329:Workforce
vernacular_title: Evaluation d'une action de santé publique pour l'amélioration de la sécurité à la naissance en Martinique: 1977-1984.