How has the free obstetric care policy impacted unmet obstetric need in a rural health district in Guinea?
In 2010, the Guinea Ministry of Health introduced a free emergency obstetric care policy in public health facilities
Abstract
Introduction
In 2010, the Ministry of Health (MoH) of Guinea introduced a free emergency obstetric care policy in all the public health facilities of the country. This included antenatal checks, normal delivery and Caesarean section.
Objective
This study aims at assessing the changes in coverage of obstetric care according to the Unmet Obstetric Need concept before (2008) and after (2012) the implementation of the free emergency obstetric care policy in a rural health district in Guinea.
Methods
We carried out a descriptive cross-sectional study involving the retrospective review of routine programme data during the period April to June 2014.
Results
No statistical difference was observed in women’s sociodemographic characteristics and indications (absolute maternal indications versus non-absolute maternal indications) before and after the implementation of the policy. Compared to referrals from health centers of patients, direct admissions at hospital significantly increased from 49% to 66% between 2008 and 2012 (p = 0.001). In rural areas, this increase concerned all maternal complications regardless of their severity, while in urban areas it mainly affected very severe complications. Compared to 2008, there were significantly more Major Obstetric Interventions for Maternal Absolute Indications in 2012 (p<0.001). Maternal deaths decreased between 2008 and 2012 from 1.5% to 1.1% while neonatal death increased from 12% in 2008 to 15% in 2012.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Citation
Delamou A, Dubourg D, Beavogui AH, Delvaux T, Kolié JS, Barry TH, et al. (2015) How Has the Free Obstetric Care Policy Impacted Unmet Obstetric Need in a Rural Health District in Guinea? PLoS ONE 10(6): doi:10.1371/journal.pone.0129162