Suchergebnisse

Research activities are part of the cooperation model developed by the Cemubac. The foundation for the research is based on strengthening the capacity of health systems and services resulting in the improvement of care offered to communities. The research (quantitative and qualitative) has a high participatory dimension and was able to develop thanks to partnerships with professionals and beneficiaries. It relies heavily on the implication of national public staff trained specifically for this work and on long-term presence in the area. The work in Kivu has continued over the past fifteen years despite a deteriorating social, economic and security context. As an organism for acquiring knowledge, the Cemubac's work in Kivu is primarily geared towards improving health services. Adapted from the source document.

This second paper aims at deriving useful information allowing to improve the strategy applied for maternal health care. MATERIAL AND METHODOLOGY: Between 1980 and 1998, data on 13,042 deliveries were collected. Characteristics, mortality, morbidity of mothers and new-born and obstetrical interventions were recorded. The present work describes the evolution of low birth weight (LBW), new-born deaths, and associated risk factors. The statistical analyses applied included khi2, t-test, and multiple logistic regression. RESULTS: Eighteen percent of new-born weights below 2.5 kg and 7.9% died. The proportion of low birth weights remains globally constant. Low proportions of new-born deaths were observed in 1981, 1982, 1988 and 1998. At admission, 35% of the women presented at least one of the four risks defined by the factors used for reference; this proportion went up from 26.1 to 39.2%. The four reference factors were associated with low birth weight. Baudelocque diameter and age were not associated with new-born death. Education and BMI were associated with an increased risk of new-born death. Marital status was not associated with any of the two outcomes. CONCLUSION: This analysis shows small variation of LBWs and perinatal deaths. It confirms the association between these two outcomes and most of the risk factors studied. The efficacy of the strategies implemented for improving perinatal health is questioned. The authors recommend that they be reassessed. ; Peer reviewed

This report is the first of 2 papers that analyse data routinely collected in the maternity ward of Rutshuru (democratic Republic of Congo). The present work describes the evolution of caesarean section, maternal deaths and the associated risk factors. MATERIAL AND METHODOLOGY: Between 1980 and 1998, data on 13,042 deliveries were collected. Characteristics, mortality, morbidity of mothers and new-borns and obstetrical interventions were recorded. The statistical analyses applied included khi2, t-test, simple linear and multiple logistic regression. RESULTS: Fifteen percent had a caesarean section and 1.9% of women died. When referred to the expected births during the period, these numbers led to a ratio of 150 maternal deaths for 100,000 expected births and a ratio of caesarean section of 1.2%. At admission, 35% of the women presented at least one of the four risk factors used for reference. The proportion of women with at least one of the 4 risk factors went up from 26.1% to 39.5%. The proportion of caesarean sections went up from 1.9% to 34.1%. The proportion of maternal deaths remained constant except in 1988, 1994, 1995 and 1997. Three of the four reference factors, the Baudeloque diameter, parity and height were associated with caesarean section. Age only was associated with maternal death. Education and marital status were both associated with caesarean section and maternal death. CONCLUSION: This analysis shows high levels of maternal mortality and caesarean section. The authors recommend to analyse on a larger scale the value of the reference factors used in antenatal services and to standardise indications for the different obstetrical interventions. ; Peer reviewed

The population of eastern Kivu, like that of Rwanda, has been surviving in critical conditions for many years. The Rwandan refugees of 1994 fled into an area with its own serious problems. The Zairean health services in the health districts of Rutshuru, Kirotshe and Masisi, in spite of the political and socioeconomic disintegration of the country, were still functioning, and the local hospitals and health centres, although overwhelmed, contributed to a large extent to the disaster response. Prominent among the major problems facing the local health services were their limited adaptability, the inadequate coordination and collaboration offered to them by the humanitarian aid agencies, and the discrimination between the direct and secondary victims of the emergency. The public health consequences of the Rwandan refugee crisis for the Zairean population constitute an integral part of the disaster. ; Peer reviewed