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Qualité des soins pour prévenir et traiter l'hémorragie du postpartum et la pré- éclampsie/ éclampsie : une évaluation fondée sur l'observation dans les hôpitaux de Madagascar

Journal Article
(Published May, 2013)
Bazant, E. (Author),
Rakotovao, J.P. (Author),
Rasolofomanana, J.R. (Author),
Tripathi, V. (Author),
Gomez, P. (Author),
Favero, R. (Author),
Moffson, S. (Author)
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To guide the quality improvement processes at hospitals in Madagascar, this study assessed the quality of care at facilities with respect to interventions addressing the main causes of maternal and newborn complications, with a focus on postpartum hemorrhage (PPH) and pre-eclampia/eclampsia (PE/E). The study looked at 36 health facilities with high volume of deliveries by conducting inventories of medications and material, interviews with 139 health providers, and observations of 323 antenatal consultations and 347 labor and delivery clients.

Results showed that quality improvement is needed to provide prophylactic oxytocin to all women within one minute of delivery, and to supply magnesium sulfate to all maternities for treatment of severe PE/E, among other interventions. To build on existing favorable policies to improve maternal and newborn health care in Madagascar, quality improvement efforts should target provider and facility readiness, update and operationalize national guidelines and protocols, and implement a national strategy that includes performance-based recognition of providers and facilities.

Article was published in French. 

Citation: 
Bazant E, Rakotovao JP, Rasolofomanana JR, Tripathi V, Gomez P, Favero R, et al. [Quality of care to prevent and treat postpartum hemorrhage and pre-eclampsia/eclampsia : an observational assessment in Madagascar's hospitals]. Medecine et sante tropicales. 2013 May 1;23(2):168-75.