Réduction de la mortalité maternelle et néonatale par la gratuité de la cesarienne a l’Hôpital Nianankoro Fomba de Ségou au Mali

Introduction: Emergency obstetrical treatment could influence maternal and neonatal mortality and so the government of the republic of Mali decided on June 23, 2005 to establish the free caesarian policy in the public sanitary establishments. So after 3 years and half, we estimated the impact of free caesarian policy on the maternal and neonatal mortality. Method: It was about a comparative transverse study concerning the women having a caesarian since their admittance until their exit of the hospital. Study covered a period of 5 years; 18 months before the wantonness and 42 current months wantonness. Data were seized and analyzed on the software info 6.4. Used statistical test is Pearson's Chi-2 and the threshold is fixed in p = 0, 05. Results: Frequency of the caesarian increased with caesarian free policy is 25.48 % in 2008 versus 9.33 % in 2004 (p = 0, 0067). Maternal mortality rate was improved: 3, 85 % in 2004 versus 0.23 % in 2008. The rate of neonatal mortality in the same period passes from 25, 39 % to 9, 36 % (P = 0,021). Conclusion: Free caesarian policy allowed, not only to increase the total number of caesarian but also to improve the rates of maternal and neonatal and mortality.