Facteurs associés aux accouchements non assistés: méta - analyse des données de l'enquête démographique et de santé 2006 du Mali

Abstract

Context: Despite a high prevalence of delivery assisted by non-skilled birth attendant in Mali, 51% in 2006, its determinants notably contextual ones remained poorly studied. Objective: we aimed at investigating individual and contextual factors associated to delivery assisted by non- skilled birth attendant (NSBA) among women aged 15-49 years in Mali. Setting: Population-based using the most recent and available representative probability survey sample of Mali. Design: Retrospective analytical study based on cross- sectional data. Population: Women aged 15-49 years (n= 14583) from the Malian Demographic and Health Survey of 2006. Our unit of analysis was the last delivery. As a result, our analytical sample drawn from this survey on last deliveries within five years prior to the survey was 9036 mothers. Analyses: We firstly performed weighted descriptive analyses of population characteristics. Afterwards, bivariate and multiple Robust Poisson models were fitted to estimate associations between individual, household and contextual characteristics and delivery assisted by non-skilled birth attendant. Results: The overall weighted prevalence of last delivery assisted by NSBA in Mali was 48.6% (95% CI = 45.4Ŕ 51.8)in 2006.. Furthermore, less than weekly community"s no exposition to health programs through radio and TV and community poverty were strongly associated to delivery assisted by NSBA. Adjusted analyses showed that delivery assisted by NSBA was strongly influenced by no parental schooling, low community socioeconomic status, living in rural area and absence of weekly exposition radio or TV. Conclusion: Our findings highlight that delivery assisted by NSBA in Mali was both determined by individual and community factors. Thus, these conditions should be taken into account in the development of future prevention strategies aimed to decrease a persistently higher prevalence of delivery assisted by NSBA in Mali.