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dc.contributor.authorVan Damme, W
dc.contributor.authorDe Brouwere, V
dc.contributor.authorBoelaert, M
dc.contributor.authorVan Lerberghe, W
dc.date.accessioned2008-05-28T13:17:17Z
dc.date.available2008-05-28T13:17:17Z
dc.date.issued1998-05-30
dc.identifier.citationEffects of a refugee-assistance programme on host population in Guinea as measured by obstetric interventions. 1998, 351 (9116):1609-13 Lanceten
dc.identifier.issn0140-6736
dc.identifier.pmid9620714
dc.identifier.doi10.1016/S0140-6736(97)10348-8
dc.identifier.urihttp://hdl.handle.net/10144/28614
dc.description.abstractBACKGROUND: Since 1990, 500000 people have fled from Liberia and Sierra Leone to Guinea, west Africa, where the government allowed them to settle freely, and provided medical assistance. We assessed whether the host population gained better access to hospital care during 1988-96. METHODS: In Guéckédou prefecture, we used data on major obstetric interventions performed in the district hospital between January, 1988, and August, 1996, and estimated the expected number of births to calculate the rate of major obstetric interventions for the host population. We calculated rates for 1988-90, 1991-93, and 1994-96 for three rural areas with different numbers of refugees. FINDINGS: Rates of major obstetric interventions for the host population increased from 0.03% (95% CI 0-0.09) to 1.06% (0.74-1.38) in the area with high numbers of refugees, from 0.34% (0.22-0.45) to 0.92% (0.74-1.11) in the area with medium numbers, and from 0.07% (0-0.17) to 0.27% (0.08-0.46) in the area with low numbers. The rate ratio over time was 4.35 (2.64-7.15), 1.70 (1.40-2.07), and 1.94 (0.97-3.87) for these areas, respectively. The rates of major obstetric interventions increased significantly more in the area with high numbers of refugees than in the other two areas. INTERPRETATION: In areas with high numbers of refugees, the refugee-assistance programme improved the health system and transport infrastructure. The presence of refugees also led to economic changes and a "refugee-induced demand". The non-directive refugee policy in Guinea made such changes possible and may be a cost-effective alternative to camps.
dc.language.isoenen
dc.publisherElsevieren
dc.rightsReproduced on this site with permission of Elsevier Ltd. Please see [url]http://www.thelancet.com/[/url] for further relevant comment.en
dc.subject.meshAdulten
dc.subject.meshDelivery of Health Careen
dc.subject.meshFemaleen
dc.subject.meshGuineaen
dc.subject.meshHealth Services Accessibilityen
dc.subject.meshHealth Services Administrationen
dc.subject.meshHumansen
dc.subject.meshLiberiaen
dc.subject.meshMaleen
dc.subject.meshObstetric Surgical Proceduresen
dc.subject.meshPoisson Distributionen
dc.subject.meshPregnancyen
dc.subject.meshRefugeesen
dc.subject.meshRelief Worken
dc.subject.meshRetrospective Studiesen
dc.subject.meshRural Populationen
dc.subject.meshSierra Leoneen
dc.subject.meshTransportationen
dc.titleEffects of a refugee-assistance programme on host population in Guinea as measured by obstetric interventions.en
dc.contributor.departmentDepartment of Public Health, Institute of Tropical Medicine, Antwerp, Belgium. wvdamme@itg.been
dc.identifier.journalLanceten
refterms.dateFOA2019-03-04T10:31:00Z
html.description.abstractBACKGROUND: Since 1990, 500000 people have fled from Liberia and Sierra Leone to Guinea, west Africa, where the government allowed them to settle freely, and provided medical assistance. We assessed whether the host population gained better access to hospital care during 1988-96. METHODS: In Guéckédou prefecture, we used data on major obstetric interventions performed in the district hospital between January, 1988, and August, 1996, and estimated the expected number of births to calculate the rate of major obstetric interventions for the host population. We calculated rates for 1988-90, 1991-93, and 1994-96 for three rural areas with different numbers of refugees. FINDINGS: Rates of major obstetric interventions for the host population increased from 0.03% (95% CI 0-0.09) to 1.06% (0.74-1.38) in the area with high numbers of refugees, from 0.34% (0.22-0.45) to 0.92% (0.74-1.11) in the area with medium numbers, and from 0.07% (0-0.17) to 0.27% (0.08-0.46) in the area with low numbers. The rate ratio over time was 4.35 (2.64-7.15), 1.70 (1.40-2.07), and 1.94 (0.97-3.87) for these areas, respectively. The rates of major obstetric interventions increased significantly more in the area with high numbers of refugees than in the other two areas. INTERPRETATION: In areas with high numbers of refugees, the refugee-assistance programme improved the health system and transport infrastructure. The presence of refugees also led to economic changes and a "refugee-induced demand". The non-directive refugee policy in Guinea made such changes possible and may be a cost-effective alternative to camps.


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