Maternal mortality in the context of political free health care on pregnancy and birth to the Treichville teaching hospital, Abidjan-Côte d’Ivoire

Ignace N’guessan Yao, Privat Yéret Guié, Jean-Marc Lamine Dia, Paul-Eric Kouamé Bohoussou, Edouard Konan N’guessan, Corneille Téa Saki, Simplice Danho Anongba


Background: Maternal mortality continues to be a drama in the countries of Sub Saharan Africa. Despite the efforts of the world through the millennium development goals (MDGs) 5 and 6, the situation remains very worrying in this region. If in developed countries, maternal mortality is an indicator of the quality of obstetric care, for poor countries, it is an indicator of social and economic development.

Methods: Our study was designed to assess the impact of free support of pregnancy and childbirth on maternal mortality at treichville teaching hospital in Abidjan. We conducted a retrospective descriptive study of deaths of our service over the period September 2012 to August 2013 taking into account the hospital data.

Results: During this period, we recorded 32 deaths per 3173 live births. Eight out of ten patients were younger than 35 years. And half had no education. 93.75% of patients were evacuated to another structure and more than half of the deaths occurred less than two hours after admission to our service. Bleeding causes dominate with 37.50% of postpartum haemorrhage.

Conclusions: Maternal death rates in our service remain high despite the policy of free care and factors of this mortality remain unchanged for decades.


Free care - CHU Treichville, Abidjan

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Bouvier-Colle MH. Mortalité maternelle. EMC Elsevier Masson SAS, Paris, Obstétrique. 2011;5:082-D10.

WHO International statistical classification of diseases and related health problems, 10th revision, Geneva, WHO; 1992:1.

EDS Enquête Démographique de Santé Côte d’Ivoire; 2011-2012.

Saucedo M, Deneux-Tharaux C, Bouvier-Colle MH. Rapport du comité national d’experts sur la mortalité maternelle : epidémiologie de la mortalité maternelle en France, 2007-2009. J Gynecol Obstet Biol Reprod. 2013;42:613-27.

Bouvier-Colle M, Deneux-Tharaux C, Saucedo M. Rapport du Comité national d’experts sur la mortalité maternelle, 2001-2006. Saint-Maurice (Fra) : Institut de Veille Sanitaire; 2010;99.

Schutte J, Steegers A, Schuitemaker N, Santema J, De Boer K, Pel M, et al. Rise in maternal mortlity in the Netherlands. BJOG. 2010;117:399-406.

Bouvier-Colle M. Epidémiologie de la mortalité maternelle en France, fréquence et caractéristiques. Réanimation. 2007;16:358-65.

Hartocollis A. High rates for deaths of pregnant women in New York state. The New York Times. 2010;(A16).

Olsen B, Hinderaker S, Kazaura M, Lie R, bergsjo P, Gasheka P, et al. Estimates of maternal mortality by the sisterhood method in rural northern Tanzania: a hgouselhold sample and an antenatal clinic sample. BJOB. 2000;107:1290-7.

Bragg R. Maternal deaths and vulnerable migrants. Lancet. 2008;371:879-80.

Philibert M, Deneux-tharaux C, Bouvier-colle M. can excess maternal mortality among women of foreign nationality be explained by suboptimal obstétric care? Br J Obstet Gynaecol. 2008;115:1411-8.

Fenomanana MS, Riel AM, Rakotomena SD, Andrianjatovo JJ, Andrianampanalinarivo HR. Les facteurs de risque de mortalité par hémorragie du post patum à la Maternité de Mafelatanana-CHU Antananarivo-Madagascar. Revue d’Anesthésie-Réanimation et de Médecine d’Urgence. 2009;1(3):4-7.

Bohoussou KM, Boni AW, Anongba S, Djanhan Y, Sangaret M. La mortalité maternelle au cours de la parturition et le post-partum immédiat. Afr Med. 1986;238:125-30.

Andriamady Rasoarimahandry CL, Rakotoarimanana M, Ranjahaly RJ. Mortalité maternelle à la maternité de befelatanana CHU d’Antananarivo (1988-1997). J Gynecol obstet Biol Reprod. 2000;29:501-8.

Bergsjo P, Vangen S, Lie R, Lyatou R, Lie-Nielsen E, Oneko O. Recording of maternal deaths in an East African university hospital. Acta Obstet Gynecol Scand. 2010;89:789-93.

Olsen B, Hinderaker S, Bergsjo P, Lie R, Olsen O, Gasheka P, et al. Causes and characteristics of maternel deaths in rural northern Tanzania. Acta Obstet Gynecol Scand. 2002;81:1101-9.

Adamu Y, Salihu H, Sathiakumar N, Alexander G. Maternel mortality in Northern Nigeria: a population based study. Eur J Obstet Gynecol Reprod Biol. 2003;109:153-9.

Bouvier-Colle MH, Saucedo M, Deneux-Tharaux C. The confidential enquiries into maternal deaths, 1996-2006 in France: what consequences for the obstetrical care? J Obstet Gynecol Reprod Biol. 2011;40:87-102.

Ouédraogo C, Bouvier-Colle MH. Mortalité maternelle en Afrique de l’Ouest: comment, combien et pourquoi? J Gynecol Obstet Biol Reprod. 2002;31:80-9.

Alihonou E. Mortalité maternelle en Afrique Sub-Saharienne. Journal de la SAGO. 2000;1:24-32.