@article{fdi:010068245,
  title = {{DECIDE} : a cluster randomized controlled trial to reduce non-medically indicated caesareans in {B}urkina {F}aso},
  author = {{K}abor{\'e}, {C}. and {R}idde, {V}. and {K}ouanda, {S}. and {Q}ueuille, {L}. and {S}om{\'e}, {P}. {A}. and {A}gier, {I}. and {D}umont, {A}lexandre},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {S}ince 2006, {B}urkina {F}aso has subsidized the cost of caesarean sections to increase their accessibility. {C}aesareans are performed by obstetricians, general practitioners, and nurses trained in emergency surgery. {W}hile the national caesarean rate is still too low (only 2 % in 2010), 12 to 24 % of caesareans performed in hospital are, in fact, not medically indicated. {T}he objective of this study is to evaluate the effectiveness and analyze the implementation of a multi-faceted intervention to lower the rate of non-medically indicated caesareans in {B}urkina {F}aso. {M}ethods: {T}his study combines a multicentre cluster randomized controlled trial with an implementation analysis in a mixed-methods approach. {T}he evidence-based intervention will consist of three strategies to improve the competencies of maternity teams: 1) clinical audits based on objective criteria; 2) training of personnel; and 3) decision-support reminders of indications for caesareans via text messages. {T}he unit of randomization and of intervention is the public hospital equipped with a functional operating room. {U}sing stratified randomization on hospital type and staff qualifications, 11 hospitals have been assigned to the intervention group and 11 to the control group. {T}he intervention will cover 1 year. {E}very patient who delivered by caesarean during a 6-month period in the year preceding the intervention and the 6 months following its end will be included in the trial. {T}he change in the rate of non-medically indicated caesareans is the main criterion by which the intervention's impact will be assessed. {T}o analyze the intervention process, a longitudinal qualitative study consisting of deliberative workshops and individual in-depth interviews will be conducted. {T}he target outcome is a 50 % reduction in the rate of non-medically indicated caesareans. {D}iscussion: {T}his study will provide evidence regarding the effectiveness of a multi-faceted intervention for reducing non-medically indicated caesareans in a low-income country. {B}y combining qualitative and quantitative methods, the study's findings will allow understanding the factors that could influence the intervention process and ultimately the intended outcomes.},
  keywords = {{N}on medically indicated caesarean ; {T}rial ; {A}udit ; {T}raining ; {SMS} based reminders ; {SMS} ; {M}ixed methods ; {P}rocess analysis ; {B}urkina {F}aso ; {BURKINA} {FASO}},
  booktitle = {},
  journal = {{BMC} {P}regnancy and {C}hildbirth},
  volume = {16},
  numero = {},
  pages = {art. 322 [12 p.]},
  ISSN = {1471-2393},
  year = {2016},
  DOI = {10.1186/s12884-016-1112-8},
  URL = {https://www.documentation.ird.fr/hor/fdi:010068245},
}