Knowledge, attitudes and practices of obstetrical ultrasound in Conakry, Guinea

Background: The authors report an initial assessment of the practice of obstetrical ultrasound in Conakry in order to make suggestions to improve the quality of services in Guinea.Methods: It is about a cross-sectional study of three months (August 1st to October 31st, 2013) conducted in Conakry. The study population consisted of health personnel performing fetal ultrasounds in Conakry and who agreed to participate in the survey. The data collected were about the socio-professional characteristics of the service providers, their knowledge and attitudes. The data were analyzed in a simple descriptive statistical analysis way. The results were analyzed according to the norms and standards issued by the French Fetal Ultrasound College and the National Technical Committee for Prenatal Diagnosis Ultrasound.Results: Twenty one service providers over twenty-six (80.8%) were male (80.8%) aged 40-49 years old (46.2%), obstetrician-gynecologists (76.9%), working in a public hospital (46.2%) and not having an ultrasound degree (59.2%). Eight service providers over twenty-six ((30.8%) affirmed knowing the recommended period for a fetal biometry. The majority (60%) indicated measuring the nuchal translucency and 85.2% (22/26) the craniocaudal length. The anatomical landmarks were not correctly identified in 75.2% of cases for the biparietal and the head circumference and in 63.8% of cases for abdominal circumference. Nine service providers over twenty-six (34.6%) affirmed explaining the limitations of ultrasound. Eighteen devices over twenty-six (69.2%) had more than 9 years of age, 73% (19/26) of them did not have a vaginal probe and 65.3% (17/26) did not have a pulsed wave Doppler.Conclusions: Improving the quality of the practice of obstetrical ultrasound in Guinea goes through training of service providers, establishing distribution and compliance with norms and standards as well as quality control of ultrasound devices

Assessment of Post-abortion Care Services in Two Health Facilities in Conakry, Guinea

High quality post-abortion care (PAC) is needed to curb maternal deaths by providing effective treatment and preventing future unintended pregnancies through PAC family planning. This study aimed at assessing PAC services with a focus on women‘s satisfaction with care they received in two health facilities in Conakry. We conducted a cross-sectional mixed method study with 426 PAC clients from March 1st to August 31st, 2014. Data analyses were performed using Stata software version 14 for quantitative data and using a thematic approach for qualitative data. Overall, 92.5% of women were satisfied with PAC services they received. The short waiting time (< 30 min), the appropriate management of pain during the treatment, the affordable cost of the treatment, the confidentiality of services, the good patient-provider interaction and the cleanliness of the premises were factors statistically significantly associated with the satisfaction of women (P-value ˂ 0.001). This study showed a high rate ofwomen‘s satisfaction. Nevertheless, health authorities should assure a regular follow-up on the application of official prices for the treatment of PAC patients; and providers should further consider aspects such as pain management during treatment, confidentiality of services, patient-provider interaction for optimal satisfaction of clients with PAC services. Keywords: Assessment, Post-abortion care, Health facilities, GuineaDes soins post-avortement (SAA) de haute qualité sont nécessaires pour réduire les décès maternels en fournissant un traitement efficace et en prévenant les futures grossesses non désirées grâce à la planification familiale après-avortement. Cette étude visait à évaluer les services de SAA en mettant l'accent sur la satisfaction des femmes à l'égard des soins qu'elles ont reçus dans deux établissements de santé à Conakry. Nous avons mené une étude transversale à méthodes mixtes auprès de 426 clientes de SAA du 1er mars au 31 août 2014. Les analyses de données ont été réalisées à l'aide du logiciel Stata version 14 pour les données quantitatives et en utilisant une approche thématique pour les données qualitatives. Dans l'ensemble, 92,5% des femmes étaient satisfaites des services de SAA qu'elles ont reçus. Le temps d'attente court (<30 min), la gestion appropriée de la douleur pendant le traitement, le coût abordable du traitement, la confidentialité des services, la bonne interaction patiente -prestataire et la propreté des locaux étaient des facteurs statistiquement significativement associés à la satisfaction des femmes (valeur P ˂0,001). Cette étude a montré un taux élevé de satisfaction des femmes. Néanmoins, les autorités sanitaires devraient assurer un suivi régulier de l'application des prix officiels pour le traitement des patientes de SAA; et les prestataires devraient en outre prendre en compte des aspects tels que la gestion de la douleur pendant le traitement, la confidentialité des services, l'interaction patiente-prestataire pour une satisfaction optimale des clientes à l‘égard des services de SAA. Mots-clés: Évaluation, Soins post-avortement, Établissements de santé, Guiné