Midwives’ Professional Satisfaction and the Quality of Obstetric Care in Developing Country

Introduction: In Africa, poor working conditions affect the motivation of health care providers. The objective is to study midwives’ professional satisfaction on the technical quality of emergency obstetric care in Senegal. Material and Methods: This was a prospective study of 16 hospitals in Senegal. The job satisfaction of midwives was measured during a personal interview. The instrument used was validated in Senegal and Mali. Other data collected relate to professional and institutional characteristics. A treatment observation grid was used to measure the quality of obstetric care in labour wards. Mixed-model linear regression was used to estimate the effect of satisfaction on the quality of obstetric care. Results: A total of 65 midwives were interviewed and 325 patients observed. The average quality score was 8.7 ± 1.7. The satisfaction scores ranged from 42.2 ± 17.4 (salary) to 76.7 ± 12.1 (morale satisfaction). A positive and significant correlation was found between quality of care and management (cc = 0.56), remuneration (cc = 0.40), task (cc = 0.32), workload (cc = 0.24) and training (cc = 0.29). The linear mixed model shows that salary (β = 0.40), continuing education (β = 0.17) and management style (β = 0.42) improved the quality of care. Association between moral satisfaction and quality care was negative (β = ﹣0.53). Conclusion: The satisfaction of health professionals is a major determinant of the quality of obstetric care. Its inclusion in the fight against mortality has become imperative in developing.

Practice of the Caesarean Section in Four Maternities in Benin Using Robson Classification

Objective: To measure for each of the ten (10) groups of women defined in Robson’s classification, the cesarean section rate, group size and its contribution to the overall cesarean section rate in four maternities in Benin. Methods: This was a retrospective study over a period of 3 years, from January 1, 2014 to December 31, 2016. Two workshops were organized for training in data collection and interpretation of results. Results: A total of 5442 files were included for the four health facilities during the study period. The overall cesarean section rate was 43.9%. The most represented group (30.3%) was multiparous women without scarred uterus, with a single term fetus, in cephalic presentation, and spontaneous labour (Group 3). The largest contributor to the overall cesarean section rate was that of multiparous women with at least one uterine scar with a single fetus, eventually in cephalic presentation (Group 5) with 29.5%. Conclusion: Caesarean section rates are high in groups of women with a favourable prognosis for vaginal delivery. It is also high in women with scarred uterus (Group 5).