title: [Conditions of midwifery practice in Tunisia rural areas and maternal transfer].
abstract: OBJECTIVE
  This survey analyzed the conditions of midwife practice in rural maternity hospitals and their influence on maternal transfer in a sanitary region of northwestern Tunisia, an underprivileged region where transfer rate is the highest in the country.
  
  
  METHODS
  The study concerned midwives in 8 rural maternity hospitals. The survey included the files of 1,065 women transferred to the regional maternity hospital over a one year period.
  
  
  RESULTS
  The hospitals surveyed operated without a gynecologist. Conditions of practice varied from one hospital to another and had a clear influence on transfer rate.
  
  
  CONCLUSIONS
  Our findings illustrated the importance of certain remediable insufficiencies including technical facilities, the level of midwife supervision, physician responsibility within the sanitary area, and assignment of gynecologists to the rural hospitals where a large volume of activity occurs. Improvements can be made in use of maternity hospitals to reassure women and midwives.
authors.affiliation: Centre de santé de base de Kalâa, Khasba, Le Kef, 7113 Tunisie.
authors.forename: M
authors.initials: M
authors.lastname: Khalfaoui
authors.forename: M
authors.initials: M
authors.lastname: Njah
authors.forename: H
authors.initials: H
authors.lastname: Zoghlami
mesh_terms: D005260:Female; D006771:Hospitals, Maternity; D006780:Hospitals, Rural; D006801:Humans; D008880:Midwifery; D010360:Patient Transfer; D011247:Pregnancy; D011787:Quality of Health Care; D012424:Rural Population; D014416:Tunisia