Abstract:
BACKGROUND:Since 2006, Burkina Faso has subsidized the cost of caesarean sections to increase their accessibility. Caesareans are performed by obstetricians, general practitioners, and nurses trained in emergency surgery. While the national caesarean rate is still too low (only 2 % in 2010), 12 to 24 % of caesareans performed in hospital are, in fact, not medically indicated. The objective of this study is to evaluate the effectiveness and analyze the implementation of a multi-faceted intervention to lower the rate of non-medically indicated caesareans in Burkina Faso. METHODS:This study combines a multicentre cluster randomized controlled trial with an implementation analysis in a mixed-methods approach. The evidence-based intervention will consist of three strategies to improve the competencies of maternity teams: 1) clinical audits based on objective criteria; 2) training of personnel; and 3) decision-support reminders of indications for caesareans via text messages. The unit of randomization and of intervention is the public hospital equipped with a functional operating room. Using stratified randomization on hospital type and staff qualifications, 11 hospitals have been assigned to the intervention group and 11 to the control group. The intervention will cover 1 year. Every patient who delivered by caesarean during a 6-month period in the year preceding the intervention and the 6 months following its end will be included in the trial. The change in the rate of non-medically indicated caesareans is the main criterion by which the intervention's impact will be assessed. To analyze the intervention process, a longitudinal qualitative study consisting of deliberative workshops and individual in-depth interviews will be conducted. The target outcome is a 50 % reduction in the rate of non-medically indicated caesareans. DISCUSSION:This study will provide evidence regarding the effectiveness of a multi-faceted intervention for reducing non-medically indicated caesareans in a low-income country. By combining qualitative and quantitative methods, the study's findings will allow understanding the factors that could influence the intervention process and ultimately the intended outcomes. TRIAL REGISTRATION:The DECIDE trial is registered on the Current Controlled Trials website under the number ISRCTN48510263 on January 28, 2014.
journal_name
BMC Pregnancy Childbirthjournal_title
BMC pregnancy and childbirthauthors
Kaboré C,Ridde V,Kouanda S,Queuille L,Somé PA,Agier I,Dumont Adoi
10.1186/s12884-016-1112-8subject
Has Abstractpub_date
2016-10-21 00:00:00pages
322issue
1issn
1471-2393pii
10.1186/s12884-016-1112-8journal_volume
16pub_type
杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:Vasa praevia (VP) is an obstetric condition that is associated with significant perinatal mortality and morbidity. Although the incidence of VP is low, it is one of the few causes of perinatal death that can be potentially prevented through detection and appropriate care. The experience of women diagnosed wi...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-14-318
更新日期:2014-09-10 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-14-144
更新日期:2014-04-15 00:00:00
abstract:BACKGROUND:Childbirth confidence is an important marker of women's coping abilities during labour and birth. This study investigated socio-demographic, obstetric and psychological factors affecting self-efficacy in childbearing women. METHOD:This paper presents a secondary analysis of data collected as part of the BEL...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-015-0465-8
更新日期:2015-02-13 00:00:00
abstract:BACKGROUND:Given the sudden and unexpected nature of an emergency caesarean section (EmCS) coupled with an increased risk of psychological distress, it is particularly important to understand the psychosocial outcomes for women. The aim of this systematic literature review was to identify, collate and examine the evide...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-019-2687-7
更新日期:2019-12-30 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12884-016-0988-7
更新日期:2016-08-03 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-1722-4
更新日期:2018-04-12 00:00:00
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journal_title:BMC pregnancy and childbirth
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更新日期:2019-05-08 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,评审
doi:10.1186/s12884-018-2110-9
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journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,随机对照试验
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2013-12-05 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-017-1401-x
更新日期:2017-07-17 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-019-2478-1
更新日期:2019-10-11 00:00:00
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pub_type: 杂志文章
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更新日期:2013-01-16 00:00:00
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pub_type: 杂志文章
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更新日期:2020-08-08 00:00:00
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更新日期:2017-01-03 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2009-05-07 00:00:00
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pub_type: 杂志文章
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更新日期:2014-06-13 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2019-10-21 00:00:00
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更新日期:2021-01-18 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2012-11-13 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2014-04-12 00:00:00
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pub_type: 杂志文章,评审
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