title: [Pregnancy and delivery in western Africa. Towards a lower risk motherhood?].
abstract: The maternal mortality ratio is the health indicator displaying the greatest disparity between industrialized and developing countries. Medical causes have been better known since a decade ago but the non medical causes must be studied to develop appropriate strategies. Socio-economic causes play an important role but the poor performances of the maternal health services are directly responsible for the great majority of the deaths. The lack of qualified personnel, the poor management of those who are qualified, the misallocation of the rare resources, the poor relationships between health personnels and their clients, the shortages of supplies, essential drugs and blood lead to a poor quality of care to pregnant women. The Safe Motherhood Initiative has led to the development of simple but efficient strategies which would allow to dramatically reduce maternal and neonatal mortality as well as handicaps. This requires a political commitment of the governments of West Africa but, in spite of the strong advocacy of major donor agencies and international organizations, programs have yet to be implemented.
authors.affiliation: Ministère de la Santé et des Affaires Sociales, Nouakchott, République Islamique de Mauritanie.
authors.forename: A
authors.initials: A
authors.lastname: Prual
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration*; D008428:Maternal Mortality; D020380:Needs Assessment / Q000458:organization & administration; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D018566:Pregnancy, High-Risk; D011787:Quality of Health Care; D012307:Risk Factors; D012959:Socioeconomic Factors