« Le corps des sages-femmes », entre identités professionnelle et sociale

Abstract

Yannick Jaffré, Alain Prual: "The midwives corps", between professional and social identities. In subsaharian Africa, maternai mortality is a public health problem. Its rate is between 20 and 70 times higher than in industrialized countries. The most frequently cited causes concern the attitude of the populations and a lack of qualified personnel, both quantitatively and qualitatively. Logically enough, to solve this problem, the "professionals" of development hesitate between a naive valorization of traditional medicine (e.g. traditional birth attendants) and the implementation of technical programs and training programs. Several epidemiologic and anthropologie surveys, conducted in Niger, allow to better analyze the situation. In urban settings, pregnant women utilize widely public health centers, that, on the other hand, are overstaffed. An analysis of the "social identity" of nurses and midwives, of the representations they have of their profession and an analysis of the themes of the conflicts between the health personnel and the populations, allow to suggest explanatory causes of the dysfunctioning of maternal health services. Both the health personnel and the population are "trapped" in between two Systems: the System in relation to their respective social identity and the System of their professional identity. Improving the health situation in subsaharian Africa thus requires to add to the technical training programs of health personnels a qualitative training, where those problems of social identification and of professional identification would be approached in an innovative way.