Table of Contents
ISRN Obstetrics and Gynecology
Volume 2012, Article ID 649412, 8 pages
Research Article

Qualification of Staff, Organization of Services, and Management of Pregnant Women in Rural Settings: The Case of Diema and Kayes Districts (Mali)

1Department of Public Health, Faculty of Medicine, University of Montreal, 1420 Mont-Royal Boulevard, Montreal, QC, Canada H2V 4P3
2International Health Unit, Research Center of the Centre Hospitalier de l'Université de Montréal (CRCHUM), 3875 Saint-Urbain Street, Montreal, QC, H2W 1V13, Canada
3Direction Régionale de la Santé, P.O. Box 231, Kayes, Mali

Received 11 January 2012; Accepted 14 February 2012

Academic Editors: I. Figa-Talamanca and J. Sundby

Copyright © 2012 Maman Dogba et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


In Mali, a poor sub-Saharan country, maternity referral systems were implemented to combat the still-high rates of maternal mortality. This qualitative study was aimed at understanding the relationships between the qualification of staff in community health centres, the organization of services, and the management of pregnant women in the maternity referral system in Kayes, a rural region of Mali. Physicians who managed CHCs actively or passively modified work organization, the level of technology, their obstetric skills, and staffing. They also created a competitive environment and developed relationships of trust with patients and with the district health centre. These findings are helpful in orienting decision-making for better personnel management.