Social Determinants of Mixed Relations between Midwives and Pregnant Women in the Health District of Abobo-East Abidjan, Cote d'Ivoire

Pregnancy in our society is an important event that deserves special attention in each country. However, it seems that in the practical realization of pregnancy monitoring there are great differences. The health situation in Côte d’Ivoire specifically that of pregnant women, remains critical despite the efforts made by the government. Health programmes have long focused on epidemiological and demographic factors rather than on the social and institutional dimension, which may better make explicit some of the beliefs and value judgements made about pregnancy and midwifery. Such a situation may negatively influence the achievement of the third point of the Sustainable Development Goal, which envisages “to reduce the global maternal mortality ratio to below 70 per 100,000 live births by 2030”. Since the medical causes of maternal fetal deaths are preventable, it is important to understand the social determinants related to the mixed relationship between midwives and gestational carriers. This work focuses on the interactions between two categories of actors, namely midwives and pregnant women. A mixed type study (quantitative, qualitative) was conducted from June 2015 to February 2016 in the Abobo-East Health District. A total of 318 pregnant women were surveyed and 22 midwives were interviewed. The findings showed that the relationship between midwives and gestants is the result of insufficient mutual communication between both actors in the fight against maternal and infant mortality, insufficient availability of health facilities and the strengthening of human resources, as well as the quality of maternal and neonatal health services and cultural constraints. All these factors constitute an obstacle to the proper functioning of the health-care system and contribute to the low utilization of maternal health services and the persistence of maternal mortality. This study is intended to be an important lever for the sustainability of an action and Behaviour Chang