Analysis of caesarean rate and indications of university hospitals in sub-Saharan African developing countries using Robson classification system: the case of Cocody’s hospital center, Abidjan-Cote d’Ivoire

Background: According to the World Health Organization (WHO), it has become imperative to monitor caesarean rates in hospitals since these rates continue to increase; WHO recommends this monitoring by the Robson’s system. The study objective was  to describe caesarean rates in a level 3 maternity of developing country using this system, to identify the groups likely increase overall rate of caesarean.Methods: A retrospective and comparative study made in Cocody University Hospital Center (Abidjan-Cote d’Ivoire) over a period of twelve years.  A total of 21,067 women who delivered during this period by caesarean were included.Results: The overall rate of caesarean during the study period was 38.7% with a significant increase from Period I to Period II (34.8 vs. 41.7%; p ˂0.000). The subgroup 2 (nulliparas, single cephalic term pregnancy, caesarean before labor) made the greatest contribution to the overall CS rate with an increase of +5% (10.1 vs. 15.1%; p˂0,000). Women with previous CS (groups 5, 7, 8, 9, 10) increased the caesarean rate of +3.4% (7 vs. 10.4%; p˂0.000). The group 6 increased it of +2.9% (4.7 vs 7.6%; p˂0.000). Caesarean indications were dominated by fetal acute distress (24.5 vs. 22.6%; p˂0,000), then followed by fetal-pelvic disproportion (21.8 vs. 10.7%), severe preeclampsia/eclampsia (13.5 vs. 17.5%; p˂0.000), scarred uterus and breech presentation.Conclusions: Robson classification has identified the groups led to a significant increase in caesarean rates in our service and therefore has good focus our preventive actions.

Promoting regional development through a collaborative project in entrepreneurship education: lessons from a regional experiment to develop entrepreneurial competences in children and youngsters

The chapter focuses on the reflection around the relationship between entrepreneurial empowerment and regional development, based on the assumptions, methodology and results of a self-sustained supramunicipal project in entrepreneurship education, promoted by a wide network of partners representing all the municipalities of Baixo Alentejo, Portugal, and coordinated by the Polytechnic Institute of Beja (IPBeja). The project Promoting Entrepreneurship Education at the Schools of Baixo Alentejo (PEEBA) was carried out in collaboration with Elementary Schools (1st to 2nd Ciclos) and kindergartens of Baixo Alentejo with the objective to nurture entrepreneurial competencies in children and youngsters aged 3–12 through practical and experiential entrepreneurship education. It provided them with entrepreneurial skills and attitudes that will increase their opportunities, by helping them face their lives with more initiative and confidence and/or be more proactive at work, or even start their own business in a near future, in the hope that this may eventually contribute to reduce the brain drain in Baixo Alentejo. With the motto the socioeconomic future of our region will be shaped by the students we are educating now, the PEEBA is innovative and unique, since it consists in a platform that brings together all the key stakeholders in the field of entrepreneurship education within all the municipalities of a NUTS, in this particular case Baixo Alentejo, who show an interest in working collaboratively for a common goal: to create a shared ecosystem favourable to entrepreneurship and entrepreneurial capacity