[A study of the unmet needs for major obstetric interventions: the experience of Burkina Faso]

The fight against maternal mortality requires strategies adapted to every socio-economic and geographic context. To define these strategies, it is essential to have relevant information and to obtain the participation of the various actors involved. One of the indicators which summarizes the maternal mortality level and which it the basis for the mobilization of resources is the maternal mortality ratio. This ratio remains difficult to measure especially in countries with limited resources. Based on the major obstetric interventions for absolute maternal indications, the unmet needs for major obstetric intervention approach is an opportunity for developing countries. We applied this approach in Burkina Faso i) to determine the number of major obstetric interventions for absolute maternal indications carried out in 1998; ii) to quantify the deficit in major obstetric interventions for absolute maternal indications carried out in 1998. In order to do this, we conducted a retrospective study based on files in four sanitary regions. Once the data was collected, we listed 610 major obstetric interventions for absolute maternal indications (IOM/IMA). For the same period, the expected number of IOM/IMA was of 1,470, i.e. a relative global deficit of 58.5%. The analysis per sanitary district revealed disparities with deficits going from 87.5% to 15.5%. The lack of qualified personnel and of surgical infrastructures, the low economic level of the populations and the high cost of the services were identified as factors having favoured these deficits.