ACCES TO CESAREAN SECTION IN THE COVERAGE AREA OF BLITTA HEALTH DISTRICT (TOGO)

Cesarean delivery has increased considerably worldwide in recent years. This trend is also evident in Togo, where cesarean deliveries rose from 5% to 8.90% of all deliveries attended by skilled personnel between 2018 and 2022. However, as the example of the Blitta Health District (DSB) illustrates, significant territorial disparities persist, particularly between urban areas with Comprehensive Emergency Obstetric and Neonatal Care (CEONC) facilities and rural areas, which are often far from such services. The objective of this article is to analyze the influence of geographical locationand socioeconomic context on access to cesarean delivery. The methodological approach combines document analysis, direct observation, and interviews. Investigations were conducted separately with medical staff (three midwives, a gynecologist, and a social worker) and sixteen postpartum women. In addition, two village chiefs and the president of a local community development committee were also interviewed. Analysis of consultation records provided by maternity wards yielded quantitative data on prenatal consultations and cesarean sections. The research reveals that the Blitta health district has only one CEONC center, located more than 25 km from the residence of 56% of the population, and more than 60 km from the residence of another third. It is also observed that 90% of the road sections connecting the hinterland of the Blitta Health District to the CEONC in a state of advanced disrepair and barely passable.