Factors associated with non-compliance with the health pyramid in Burkina Faso: the case of direct entries for childbirth at the University Hospital-Yalgado Ouédraogo.
Keywords:
direct entry; delivery; associated factors; Burkina Faso.Abstract
In Burkina Faso, the health pyramid is not always respected by pregnant women; some of them choose the national referral centers directly to give birth. The purpose of this survey is to determine the factors associated with the direct choice of the obstetrics department of the Yalgado Ouédraogo University Hospital (CHU-YO) for deliveries. This was a cross-sectional survey conducted among parturients received in the obstetrics service between January 20 and April 05, 2015. To identify factors associated with direct choice of obstetric service, we performed univariate and then multivariate logistic regression with a significance level of 5%, with the dependent variable being direct choice of the UHC-YO. A total of 368 women in labor were included in the study and their mean age was 27.5 years (95% confidence interval "IC95%": [26.9-28.1]). Parturients were housewives in 57.1% of cases and 33.7% of them had no schooling. The prevalence of direct entry was 39%. The distance of the parturient's home from the UHC-YO (adjusted Odds ratio "ORa" =2.5; CI95% [1.49-4.18]), the spouse's level of education (ORa = 0.5 ; CI95% [0.23-0.99]), child's birth rank (ORa = 0.3, CI95% [0.08- 0.90]), and history of childbirth at the UHC-YO (ORa = 0.13; CI95% [0.06-0.31]) were associated with direct choice of the UHC-YO. The factors associated with this choice were related to social representations of obstetrical risk and perceived quality of care. In order to limit this phenomenon, it is essential to deconstruct these representations by improving communication in favor of good preparation for childbirth and respect for the health pyramid during prenatal consultations.
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