[ FACTEURS EXPLICATIFS DES DECES MATERNELS EN MILIEU HOSPITALIER : UNE ETUDE AU NIVEAU DE SIX ZONES DE SANTE DANS L’EST DE LA REPUBLIQUE DEMOCATIQUE DU CONGO ]
Volume 23, Issue 4, July 2018, Pages 559–568
Jean-Bosco Kahindo Mbeva1, Hermès Karemere2, Prudence Mitangala3, Lévis Nyavanda4, and Jean-Paul Mundama W’Itende5
1 ULB Coopération, PADISS, Bureau de Goma, RD Congo
2 Ecole régionale de Santé Publique, Université catholique de Bukavu, Bukavu, Sud-Kivu, RD Congo
3 Ecole Régionale de Santé Publique, Université catholique de Bukavu, Bukavu, Sud-Kivu, RD Congo
4 Faculté de Santé et Développement Communautaires, ULPGL, Goma, Nord-Kivu, RD Congo
5 Antenne de la Division Provinciale de la santé du Nord Kivu, Butembo, Nord Kivu, RD Congo
Original language: French
Copyright © 2018 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction: This study analyzes hospital maternal death factors in six heath zones in the East of the Democratic Republic of Congo. The objective of this study is to identify the determinants and the circumstances of the maternal deaths. Methodology: This study is descriptive and analyzes the content of the medical files and death review of the mother deaths occurred between 2009 and June 2014 in 22 referral hospitals of 6 zones of health of the province of the North Kivu in the East of the RDC. The data collected by binomials of well experimented nurses and physician about 74 mother deaths were analyzed by SPSS software. Results: The hospital maternal mortality is high (106,9 deaths for 100.000 living Births). 87, 5% cases of maternal deaths arrived in time to the referral hospitals and 69,2% of cases were well taken in charge to the primary health level centers. On the other hand, the hospital care has been judged inadequate in 83,1 % of the cases, notably because of non-suitable medical and nursing care and limited availability either of the medicines and transfusion blood. The hemorrhage was the first reason of maternal death (63,4 % of the cases) and also the eclampsia (8,5%) and infections (7%). The indirect reasons were incriminated in less than 6% of the cases. Conclusion: The high level of hospital maternal deaths, the importance of the hemorrhages and limited medical and nurse competencies in maternal deaths, put in evidence the interest to reinforce the nurse and medical competencies and the clinical governance in reference hospitals.
Author Keywords: Maternal mortality, hospital, determinant, competencies, Democratic republic of Congo.
Volume 23, Issue 4, July 2018, Pages 559–568
Jean-Bosco Kahindo Mbeva1, Hermès Karemere2, Prudence Mitangala3, Lévis Nyavanda4, and Jean-Paul Mundama W’Itende5
1 ULB Coopération, PADISS, Bureau de Goma, RD Congo
2 Ecole régionale de Santé Publique, Université catholique de Bukavu, Bukavu, Sud-Kivu, RD Congo
3 Ecole Régionale de Santé Publique, Université catholique de Bukavu, Bukavu, Sud-Kivu, RD Congo
4 Faculté de Santé et Développement Communautaires, ULPGL, Goma, Nord-Kivu, RD Congo
5 Antenne de la Division Provinciale de la santé du Nord Kivu, Butembo, Nord Kivu, RD Congo
Original language: French
Copyright © 2018 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Introduction: This study analyzes hospital maternal death factors in six heath zones in the East of the Democratic Republic of Congo. The objective of this study is to identify the determinants and the circumstances of the maternal deaths. Methodology: This study is descriptive and analyzes the content of the medical files and death review of the mother deaths occurred between 2009 and June 2014 in 22 referral hospitals of 6 zones of health of the province of the North Kivu in the East of the RDC. The data collected by binomials of well experimented nurses and physician about 74 mother deaths were analyzed by SPSS software. Results: The hospital maternal mortality is high (106,9 deaths for 100.000 living Births). 87, 5% cases of maternal deaths arrived in time to the referral hospitals and 69,2% of cases were well taken in charge to the primary health level centers. On the other hand, the hospital care has been judged inadequate in 83,1 % of the cases, notably because of non-suitable medical and nursing care and limited availability either of the medicines and transfusion blood. The hemorrhage was the first reason of maternal death (63,4 % of the cases) and also the eclampsia (8,5%) and infections (7%). The indirect reasons were incriminated in less than 6% of the cases. Conclusion: The high level of hospital maternal deaths, the importance of the hemorrhages and limited medical and nurse competencies in maternal deaths, put in evidence the interest to reinforce the nurse and medical competencies and the clinical governance in reference hospitals.
Author Keywords: Maternal mortality, hospital, determinant, competencies, Democratic republic of Congo.
Abstract: (french)
Introduction : La présente étude analyse les facteurs explicatifs des décès en milieu hospitalier dans six zones de santé à l’Est de la République Démocratique du Congo, l’objectif étant d’identifier les causes et les circonstances des décès Maternels intra-hospitaliers. Méthodologie : L’étude est descriptive et a procédé par analyse documentaire de données des dossiers et des rapports des revues des décès et par entretiens avec les prestataires, en rapport avec les décès maternels survenus entre 2009 et juin 2014 au niveau de 22 structures hospitalières de 6 zones de santé de la province du Nord Kivu à l’Est de la RDC. Ces données collectées sur fiches par des binômes d’infirmiers et médecins expérimentés, ont été encodées et analysées grâce au logiciel SPSS. Résultats : La mortalité maternelle intra-hospitalière est élevée (106,9 décès pour 100.000 Naissances vivantes) ; 87,5% des cas de décès maternels sont arrivés à temps au niveau hospitalier et 69,2% bien pris en charge au niveau des centres de santé. En revanche, la prise en charge intra hospitalière a été jugée inadéquate dans 83,1% des cas, notamment pour des raisons des prestations médicales, de nursing non appropriées et de disponibilité limitée soit des médicaments et de sang pour la transfusion. Les hémorragies ont constitué la première cause de décès (63,4% des cas), suivies des éclampsies (8,5%) et des infections (7%). Les causes indirectes sont incriminées dans moins de 6% des cas. Conclusion : Le niveau élevé de décès maternels intra-hospitaliers, l’importance des hémorragies et de l’inadéquation de prise en charge intra hospitalière dans la survenue des décès maternels, mettent en évidence l’intérêt de renforcer les compétences des prestataires et la gouvernance clinique en milieu hospitalier dans la lutte contre la mortalité maternelle.
Author Keywords: Mortalité maternelle, hôpital, déterminants, compétences, République Démocratique du Congo.
How to Cite this Article
Jean-Bosco Kahindo Mbeva, Hermès Karemere, Prudence Mitangala, Lévis Nyavanda, and Jean-Paul Mundama W’Itende, “MATERNAL DEATHS FACTORS IN HOSPITAL AREA: A SURVEY AT SIX HEALTH DISTRICTS IN THE EAST OF THE REPUBLIC DEMOCATIQUE OF CONGO,” International Journal of Innovation and Applied Studies, vol. 23, no. 4, pp. 559–568, July 2018.
