Unmet need for induction of labor in Africa: secondary analysis from the 2004 - 2005 WHO Global Maternal and Perinatal Health Survey (A cross-sectional survey)

BMC Public Health

Gulmezoglu Metin²  Mathai Matthews⁸  Souza Joao Paulo²  Shah Archana¹  Amokrane Faouzi⁶  Neves Isilda⁹  Mugerwa Kidza⁵  Wolomby-Molondo Jean-Jose^1,10  Machoki M’Mimunya⁷  Nafiou Idi⁴  Fawole Bukola³ 

[1] Department of Health Systems, Policy and Workforce, World Health Organization, Geneva, Switzerland;Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland;Department of Obstetrics & Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria;Department of Obstetrics & Gynaecology, Abdou Moumouni University, Niamey, Niger;Department of Obstetrics & Gynaecology, Makerere University, Kampala, Uganda;Ministry of Health, Algiers, Algeria;Department of Obstetrics & Gynaecology, University of Nairobi, Nairobi, Kenya;Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland;Delegacao Provincial de Saude de Luanda, Luanda, Angola;Department de Gynaecologie et Obstetrique, Cliniques Universitaire de Kinshasa, Kinshasa, Democratic Republic of Congo

关键词: Indication;    Perinatal death;    Unmet need;    Stillbirth;    Utilization;    Rate;    Induction of labor;   

Others  :  1163169
DOI  :  10.1186/1471-2458-12-722

 received in 2012-05-11, accepted in 2012-08-27,  发布年份 2012

【 摘 要 】

Background

Induction of labor is being increasingly used to prevent adverse outcomes in the mother and the newborn.This study assessed the prevalence of induction of labor and determinants of its use in Africa.

Methods

We performed secondary analysis of the WHO Global Survey of Maternal and Newborn Health of 2004 and 2005. The African database was analyzed to determine the use of induction of labor at the country level and indications for induction of labor. The un-met needs for specific obstetric indications and at country level were assessed. Determinants of use of induction of labor were explored with multivariate regression analysis.

Results

A total of 83,437 deliveries were recorded in the 7 participating countries. Average rate of induction was 4.4% with a range of 1.4 – 6.8%. Pre-labor rupture of membranes was the commonest indication for induction of labor. Two groups of women were identified: 2,776 women with indications had induction of labor while 7,996 women although had indications but labor was not induced.

Induction of labor was associated with reduction of stillbirths and perinatal deaths [OR – 0.34; 95% CI (0.27 – 0.43)].

Unmet need for induction of labor ranged between 66.0% and 80.2% across countries. Determinants of having an induction of labor were place of residence, duration of schooling, type of health facility and level of antenatal care.

Conclusion

Utilization of induction of labor in health facilities in Africa is very low. Improvements in social and health infrastructure are required to reverse the high unmet need for induction of labor.

【 授权许可】

   
2012 Fawole et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1 .

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