Obstetrical Emergencies in Ouahigouya Regional Teaching Hospital (Burkina Faso) in the Context of Insecurity Linked to Armed Groups: A Comparative Study between Patients from Precarious Security Zones and Those from Safe Areas

Abstract

Introduction: Insecurity can be an obstacle to access to emergency obstetric and newborn care, that is why we proposed to study obstetrical emergencies in Ouahigouya Regional Teaching Hospital, a referral hospital in a region plagued by insecurity linked to armed groups. Method: This was an analytical cross-sectional study with prospective data collection over a 4-month period, from June 10 to October 10, 2020. Patients from precarious security areas were compared to those from safer areas. The Chi squared and Fisher tests were used for comparison of variables. Results: Obstetric emergencies accounted for 38.62% of admissions, from which 25.59% came from precarious security zones. Age was similar in both comparison groups. However, patients from unsafe areas were more likely to reside in rural areas (p 0.001) and more likely to be in unpaid occupations (p 0.001). Prenatal visits were less frequent (p 0.01) and women were more often multigravidae (p 0.01) in the precarious security group of patients. Apart from the more frequent uterine rupture (p = 0.02) in the group from precarious security zones, diagnosed complications and maternal mortality were similar in the 2 groups, while perinatal mortality was higher in the group of patients from precarious security zones (p 0.01). Conclusion: The precarious security situation has negative consequences on maternal and perinatal morbidity and mortality. Further studies are needed for better understanding of these consequences, and improvement of health system resilience strategies, to reduce related maternal and fetal morbidity and mortality.