@article{fdi:010089886,
  title = {{T}he difficulty of questioning clinical practice : experience of facility-based case reviews in {O}uagadougou, {B}urkina {F}aso},
  author = {{R}ichard, {F}. and {O}uedraogo, {C}. and {Z}ongo, {V}. and {O}uattara, {F}atoumata and {Z}ongo, {S}. and {G}ru{\'e}nais, {M}.{E}. and {D}e {B}rouwere, {V}.},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjective : {T}o describe the implementation of facility-based case reviews (medical audits) in a maternity unit and their effect on the staff involved. {D}esign : {C}ross-sectional descriptive study. {S}etting : {A} 26-bed obstetric unit in a district hospital in {O}uagadougou, {B}urkina {F}aso. {S}ample : {S}ixteen audit sessions conducted between {F}ebruary 2004 and {J}une 2005. {T}hirty-five staff members were interviewed. {M}ethods : {A}n analysis of all the tools used in the management of the audit was performed: attendance lists, case summary cards and register of recommendations. {T}he perceptions of the staff about the audits were collected through a questionnaire administrated by an external investigator from 10 {J}une 2005 to 16 {J}une 2005. {M}ain outcome measures : {S}ession participation, types of problems identified, recommendations proposed and implemented and staff reaction to the audits. {R}esults : {O}nly 7 midwives from a total of 15 regularly attended the sessions. {E}ighty-two percent of the recommendations made during the audits have been implemented, but sometimes after a delay of several months. {I}nterviewed personnel had a good understanding of the audit goals and viewed audit as a factor in changing their practice. {H}owever, midwives highlighted problems of bad interpersonal communication and lack of anonymity during the audit sessions, and pointed out the difficulty of practising self-criticism. {C}onclusions : {A} lack of staff commitment and the resistance of maternity personnel to being evaluated by their peers or service users are reducing acceptance of routine audits. {T}he {W}orld {H}ealth {O}rganization must take all these factors into account when promoting the institutionalisation of medical audits in obstetrics.},
  keywords = {{BURKINA} {FASO} ; {OUAGADOUGOU}},
  booktitle = {},
  journal = {{BJOG} {A}n {I}nternational {J}ournal of {O}bstetrics and {G}ynaecology},
  volume = {116},
  numero = {1},
  pages = {38--44},
  ISSN = {1470-0328},
  year = {2009},
  DOI = {10.1111/j.1471-0528.2008.01741.x},
  URL = {https://www.documentation.ird.fr/hor/fdi:010089886},
}