Haiti has one of the highest rates of maternal mortality in the Caribbean.
The « Three Delays » model proposes that pregnancy-related mortality is overwhelmingly due to delays in :
(1) deciding to seek appropriate medical help for an obstetric emergency ;
(2) reaching an appropriate obstetric facility ;
and (3) receiving adequate care when a facility is reached.
This framework was used to analyze a sample of 12 maternal deaths that occurred in a longitudinal cohort of pregnant Haitian women.
Because of political upheavals in Haiti during the survey, these deaths are an underestimate of all deaths that occurred in the cohort.
Family and friend interviews were used to obtain details about the medical and social circumstances surrounding each death.
A delayed decision to see medical care was noted in eight of the 12 cases, whereas delays in transportation only appeared to be significant in two.
Inadequate care at a medical facility was a factor in seven cases.
Multiple delays were relevant in the deaths of three women.
Family and friend interviews suggest that a lack of confidence in available medical options was a crucial factor in delayed or never made decisions to seek care.
Expanding the coverage of existing referral networks, improving community recognition of obstetric emergencies, and improving the ability of existing medical institutions to deliver quality obstetric care, are all necessary. (...)
Mots-clés Pascal : Mortalité, Gestation, Qualité, Accessibilité, Soin, Demande thérapeutique, Homme, Femelle, Haiti, Antilles, Amérique Centrale, Amérique, Système santé, Organisation santé, Obstétrique
Mots-clés Pascal anglais : Mortality, Pregnancy, Quality, Accessibility, Care, Therapeutical request, Human, Female, Haiti, West Indies, Central America, America, Health system, Public health organization, Obstetrics
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0195871
Code Inist : 002B30A01B. Création : 11/09/1998.