Houngnihin Roch Appolinaire, Sossou Aphee Judith
Sante Publique. 2017 Dec 5;29(5):719-729. doi: 10.3917/spub.175.0719.
Since 2000, in the context of the Millennium development goals, Benin has reinforced its obstetric referral system in order to reduce maternal mortality. However, structural, sociocultural and economic problems continue to affect this strategy. The Cotonou University gynaecology and obstetrics clinic (CUGO), at the top of the health pyramid, is emblematic of this situation. This study was designed to elucidate the stakes involved in referral to this hospital based on analysis of the perceptions and experiences of referral personnel.
Essentially qualitative data collection was conducted by means of in-depth semi-structured interviews from July to December 2015 involving 37 people, including referred women, healthcare personnel and caregivers.
The poor quality of information given to women concerning the reasons for referral, the fear of caesarean section, considered to be inevitable, and the difficult relationships with health workers contribute to failure to comply with referral. Rumours concerning reception, waiting times and hospitalization conditions are other factors that must be taken into account. Finally, the distance from the woman's home is a decisive element in acceptance of referral by women and their families.
Referral is generally perceived as necessary in the case of complications during pregnancy, by both referred women and healthcare personnel. However, differences in points of view are observed when the woman is referred to CUGO.
自2000年以来，在千年发展目标的背景下，贝宁加强了其产科转诊系统，以降低孕产妇死亡率。然而，结构、社会文化和经济问题继续影响这一战略。位于健康金字塔顶端的科托努大学妇产科诊所（CUGO）就是这种情况的典型代表。本研究旨在通过分析转诊人员的认知和经历，阐明转诊至该医院所涉及的利害关系。
2015年7月至12月，通过对37人进行深入的半结构化访谈，收集本质上为定性的数据，这些人包括被转诊的妇女、医护人员和护理人员。
向妇女提供的关于转诊原因的信息质量差、对被认为不可避免的剖宫产的恐惧以及与医护人员的关系困难，导致未能遵守转诊要求。关于接待、等待时间和住院条件的谣言是其他必须考虑的因素。最后，妇女住所的距离是妇女及其家人接受转诊的决定性因素。
无论是被转诊的妇女还是医护人员，通常都认为在孕期出现并发症时转诊是必要的。然而，当妇女被转诊至CUGO时，观点存在差异。
