Quality of antenatal and delivery care before and after the implementation of a prevention of mother-to-child HIV transmission programme in Côte d'Ivoire.

OBJECTIVE: To assess whether implementation of a prevention of mother-to-child HIV transmission (PMTCT) programme in Côte d'Ivoire improved the quality of antenatal and delivery care services. METHODS: Quality of antenatal and delivery care services was assessed in five urban health facilities before (2002-2003) and after (2005) the implementation of a PMTCT programme through review of facility data; observation of antenatal consultations (n = 606 before; n = 591 after) and deliveries (n = 229 before; n = 231 after) and exit interviews of women; and interviews of health facility staff. RESULTS: HIV testing was never proposed at baseline and was proposed to 63% of women at the first ANC visit after PMTCT implementation. The overall testing rate was 42% and 83% of tested HIV-infected pregnant women received nevirapine. In addition, inter-personal communication and confidentiality significantly improved in all health facilities. In the maternity ward, quality of obstetrical care at admission, delivery and post-partum care globally improved in all facilities after the implementation of the programme although some indicators remained poor, such as filling in the partograph directly during labour. Episiotomy rates among primiparous women dropped from 64% to 25% (P < 0.001) after PMTCT implementation. Global scores for quality of antenatal and delivery care significantly improved in all facilities after the implementation of the programme. CONCLUSIONS: Introducing comprehensive PMTCT services can improve the quality of antenatal and delivery care in general.

[A description of the yaws infection and prevention conditions in the health district of Adzopé]. / Description de la situation du plan dans ie district sanitaire d'Adzopé : cas des localités d'Asseudji.

This article reports on a cross-sectional study which aims to describe the situation of yaws in the boroughs of Asseudji located in the health district of Adzopé. The study's population group consisted of 206 household heads, and 2182 subjects who were tested and examined for yaws. The primary sources of pollution levels for a household were domestic animal waste (100%) and garbage stored in close proximity to the household's dwelling (49%). Signs of over-crowding were found in 43.7% of households. The sore "mother yaw" is the most common manifestation of yaws (81.5%). However, the majority of household heads were ignorant of the supporting causes and risk factors (64.1%) and the contagious natures of the infection (52.9%). Among the 2182 subjects examined, 11 (5%) had contracted yaws. The proportion of households with at least one case of yaws was 3.4%. The results of this census demonstrate that swift and strong action should be taken in these towns to prevent the outbreak of an epidemic.