Evaluation de la disponibilité des personnels qualifiés en santé maternelle et néonatale à Madagascar.

In Madagascar, the position of maternal and neonatal health is worrying with a maternal mortality ratio of 478 per 100 000 live births and a neonatal and infantile mortality of 26 per 1000 live births and 42 per 1000 live births, for children younger than one month and those younger than one year, respectively. Several factors could explain this alarming maternal and neonatal state of health, including the lack of qualified health workers. Considering that several interventions were carried out to reach aims 4 and 5 of WHO and that they were not successful, it is appropriate to assess the availability of qualified health workers to provide maternal and neonatal health services in public health facilities. The cross-sectional survey used and adapted the SARA tool (Service Availability and Readiness Assessment) of the World Health Organisation in the 52 public health facilities, in 15 of the 22 regions of Madagascar. The data was collected on tablets with CommCare ODK© software and analysed by level of health facilities with SPSS20.0. There is no general practitioner in 14% of the reference hospitals and 22% of primary health centres. The median number of obstetrician-gynaecologist in hospitals that can do caesarean sections is 1. Only 20% of the 15 regions surveyed have a high proportion of qualified personnel (> 80%) in maternal and neonatal health in public health facilities. To achieve a tangible reduction of maternal and neonatal mortality, the human resource capacity and availability must be strengthened to provide maternal and neonatal services in public health facilities. [ABSTRACT FROM AUTHOR]