title: Quality of antenatal care and obstetrical coverage in rural Burkina Faso.
abstract: Improving maternal health is one of the Millennium Development Goals of the United Nations. Despite the efforts to promote maternal and neonatal care to achieve this goal, the use of delivery care remains below expectations in Burkina Faso. This situation raises the question of the quality of care offered in maternity wards. The aim of this study was to identify primary healthcare facility and antenatal care characteristics predictive of an assisted delivery in rural Burkina Faso. A cross-sectional study was carried out in Gnagna province (North-East Burkina Faso) in November 2003. The operational capacities of health facilities were assessed, and a non-participating observation of the antenatal care (ANC) procedure was undertaken to evaluate their quality. Scores were established to summarize the information gathered. The rate of professional childbirth (obstetrical coverage) was derived from the number of childbirths registered in the health facility compared to the size of the population. The established scores were related to the obstetrical coverage using non-parametric tests (Kendall). In total, 17 health facilities were visited, and 81 antenatal consultations were observed. Insufficiencies were observed at all steps of ANC (mean total score for the quality of ANC=10.3 +/- 3.0, ranging from 6 to 16, out of a maximum of 20). Health facilities are poorly equipped, and the availability of qualified staff remained low (mean total score for the provision of care was 22.9 +/- 4.2, ranging from 14 to 33). However, these scores were not significantly related to the rate of professional childbirth (tau Kendall=0.27: p=0.14 and 0.01, p=0.93 respectively). The ability of the primary health centres to provide good antenatal care remains low in rural Burkina Faso. The key factors involved in the limited use of professional childbirth relating to maternal health services may be the quality of ANC.
authors.affiliation: Institute of Research in Health Sciences, 03 BP 7192 Ouagadougou 03, Burkina Faso. laeticianikiema989@hotmail.com
authors.forename: L
authors.initials: L
authors.lastname: Nikiema
authors.forename: Y
authors.initials: Y
authors.lastname: Kameli
authors.forename: G
authors.initials: G
authors.lastname: Capon
authors.forename: B
authors.initials: B
authors.lastname: Sondo
authors.forename: Y
authors.initials: Y
authors.lastname: Martin-Prével
mesh_terms: D002050:Burkina Faso; D002983:Clinical Competence / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data*; D004389:Durable Medical Equipment / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data; D009774:Obstetrics / Q000379:methods / Q000706:statistics & numerical data; D009775:Obstetrics and Gynecology Department, Hospital / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*