EVALUATION DU SYSTEME DE REFERENCE/EVACUATION AU CENTRE DE SANTE DE REFERENCE DE LA COMMUNE II DU DISTRICT DE BAMAKO, MALI

Despite numerous studies on referral/evacuation, it still faces many organizational challenges. This was a retrospective descriptive study from January 1 st , 2012 to December 31, 2013, the purpose of which was to evaluate the referral/evacuation system in the Gynecology and Obstetrics Department of the Reference Health Center of commune II of Bamako district. This was a comprehensive systematic sampling of all patients with obstetric problems received and managed in our department. In this study, 7.65% of our patients were referred or discharged. The 14 to 19 age group was the most represented at 62.50%. Housewives were the most represented with 42.3% of cases. Stationary dilatation was the most common pattern of reference/evacuation. The qualification of the referring/ evacuating agent was not known in 49.1% of cases. The most common mode of transportation was ambulance in 71.0% of cases. There was a discrepancy between the reference / evacuation pattern and the diagnosis retained in the Reference Health Center of commune II in 55.5%. In 61.4% of the cases the delivery was carried out vaginally. We recorded 2 cases of maternal death (0.4%), the causes of which were allergy to the anesthetic product and bleeding, and 9 cases of perinatal death (1.9% of cases). The reference-evacuation, essential link of the reduction of the maternal and neonatal mortality still knows many problems in realization despite the existence of a very clear legislation in the matter. The need for an awareness of all actors is necessary to improve the maternal-fetal prognosis.