Équité d'accès aux services de vaccination dans la région sanitaire du Centre-Est, 2018, Burkina Faso.

INTRODUCTION: The Central East region of Burkina Faso has vaccine coverage which is among the lowest in the country with an epidemiological profile marked by the occurrence of measles or meningitis outbreaks. This study was conducted with the aim of carrying out an equity analysis of the organization of immunization services in this region in order to identify factors that cause potential inequities in vaccination offer. MATERIALS AND METHOD: This descriptive cross-sectional study covered the seven districts in the Central East region. Data collection was done in two weeks combined with observation method, individual interviews and document review. Part of the data was collected using a self-administered questionnaire. The data analysis was performed with the Epi info 7 software using a plan designed for this purpose. RESULTS: A total of 144 health centers in the region (93.0% coverage) were surveyed. The average distance between villages and health facilities was 5.2 km with 16.2% of villages that were located more than 10 km from a health facility. Health centers had an average of four health workers, however the urban health centers had more workers than those in rural areas. About 16% of the villages did not benefit from an on-site vaccination trip due to the unavailability of transport logistics. More than half of the health centers (53.9%) had experienced vaccine shortages in the last six months before the study. More than 5,000 safety boxes containing used syringes were stored in the districts of the region. CONCLUSION: This study identified factors potentially responsible for an inequity in providing vaccination services in the Central East region. These factors include, but are not limited to, the geographical distribution of the health centers, the availability of transport logistics, and the shortage in vaccines and deficiencies in the waste disposal system. Concerted actions should be developed, involving all stakeholders in the health system in order to address these issues.

[Equity of access to immunization services in the Center-East health region in 2018, Burkina Faso] / Équité d'accès aux services de vaccination dans la région sanitaire du Centre-Est, 2018, Burkina Faso.

INTRODUCTION: The Central East region of Burkina Faso has vaccine coverage which is among the lowest in the country with an epidemiological profile marked by the occurrence of measles or meningitis outbreaks. This study was conducted with the aim of carrying out an equity analysis of the organization of immunization services in this region in order to identify factors that cause potential inequities in vaccination offer. MATERIALS AND METHOD: This descriptive cross-sectional study covered the seven districts in the Central East region. Data collection was done in two weeks combined with observation method, individual interviews and document review. Part of the data was collected using a self-administered questionnaire. The data analysis was performed with the Epi info 7 software using a plan designed for this purpose. RESULTS: A total of 144 health centers in the region (93.0% coverage) were surveyed. The average distance between villages and health facilities was 5.2 km with 16.2% of villages that were located more than 10 km from a health facility. Health centers had an average of four health workers, however the urban health centers had more workers than those in rural areas. About 16% of the villages did not benefit from an on-site vaccination trip due to the unavailability of transport logistics. More than half of the health centers (53.9%) had experienced vaccine shortages in the last six months before the study. More than 5,000 safety boxes containing used syringes were stored in the districts of the region. CONCLUSION: This study identified factors potentially responsible for an inequity in providing vaccination services in the Central East region. These factors include, but are not limited to, the geographical distribution of the health centers, the availability of transport logistics, and the shortage in vaccines and deficiencies in the waste disposal system. Concerted actions should be developed, involving all stakeholders in the health system in order to address these issues.

[Equity of access to immunization services in the Center-East health region in 2018, Burkina Faso]. / Équité d'accès aux services de vaccination dans la région sanitaire du Centre-Est, 2018, Burkina Faso.

INTRODUCTION: The Central East region of Burkina Faso has vaccine coverage which is among the lowest in the country with an epidemiological profile marked by the occurrence of measles or meningitis outbreaks. This study was conducted with the aim of carrying out an equity analysis of the organization of immunization services in this region in order to identify factors that cause potential inequities in vaccination offer. MATERIALS AND METHOD: This descriptive cross-sectional study covered the seven districts in the Central East region. Data collection was done in two weeks combined with observation method, individual interviews and document review. Part of the data was collected using a self-administered questionnaire. The data analysis was performed with the Epi info 7 software using a plan designed for this purpose. RESULTS: A total of 144 health centers in the region (93.0% coverage) were surveyed. The average distance between villages and health facilities was 5.2 km with 16.2% of villages that were located more than 10 km from a health facility. Health centers had an average of four health workers, however the urban health centers had more workers than those in rural areas. About 16% of the villages did not benefit from an on-site vaccination trip due to the unavailability of transport logistics. More than half of the health centers (53.9%) had experienced vaccine shortages in the last six months before the study. More than 5,000 safety boxes containing used syringes were stored in the districts of the region. CONCLUSION: This study identified factors potentially responsible for an inequity in providing vaccination services in the Central East region. These factors include, but are not limited to, the geographical distribution of the health centers, the availability of transport logistics, and the shortage in vaccines and deficiencies in the waste disposal system. Concerted actions should be developed, involving all stakeholders in the health system in order to address these issues.

[Local culture and community participation: Djandioba family planning day in Burkina Faso]. / Culture locale et participation communautaire : journées du Djandioba de la planification familiale au Burkina Faso.

The combination of "local culture and community participation" as implementation support for health programmes is an effective approach to reduce cultural barriers of access to health services. These events have reduced the negative impact of perceptions, erroneous beliefs and misinformation about modern contraceptive methods commonly observed in target populations..

[Task sharing in family planning in Burkina Faso: quality of services delivered by the delegate]. / Délégation des tâches dans le domaine de la planification familiale au Burkina Faso: qualité des services offerts par le délégataire.

INTRODUCTION: we conducted a pilot study for transferring skills for intrauterine device (IUD) insertion and implants to primary health care workers (PHCWs) as well as to provide injectable contraceptives to community health workers (CHWs) in 20 Health Centers in the Tougan Health District. This was aimed to increase access to contraceptive methods in Burkina Faso. Moreover, the purpose of this study was to assess the quality of family planning (PF) services offered by these delegated (PHCWs and CHWs). METHODS: we conducted a cross-sectional, descriptive, analytical study. Data collection was based on quantitative and qualitative methods. It included the 20 health centers in the study area and all providers (54) involved in contraceptive product supply (delegators and delegatees). Nineteen (19) recipients including 10 new contraceptive users were interviewed. The method of data collection included the observation of FP services and of the working environment, document review and individual interviews. Data were analyzed using Epi info 7 and Open Epi version 3.01. software. Chi-square test and Student's t-test were used to determine whether there was significant difference between the quality of PF services offered by the delegators and that of the delegatees. RESULTS: PF service quality score in the study area was 73% for the delegators' vs 69% for the delegates. There was no statistically significant difference between these scores. However, there was a statistically significant difference between the quality score of community health workers (75.8%) and the quality score of counselors (delegators; 87.5%) (P <0.05). It was the same for quality score determining who was eligible for implants. The quality score of PHCWs was higher than that of delegators: 79% for delegators, 64% for delegatees. CONCLUSION: this purpose of this study was to improve the geographic coverage for long-acting contraceptive methods. Under certain conditions (skills-building, monitoring, coaching), it is possible to extend the transferring of skills for long-acting contraceptive methods to PHCWs as well as the provision of injectable contraceptives to CHWs, while maintaining a satisfactory level of FP service quality.

[Fight against maternal mortality in rural areas: decentralization of emergency obstetric cares in Burkina Faso]. / Lutte contre la mortalité maternelle en milieu rural: décentralisation de l'offre des soins obstétricaux d'urgence au Burkina Faso.

INTRODUCTION: In order to cover the shortage of midwives (MWs) in the health district of Tougan, Burkina Faso, a strategy for the decentralization of emergency obstetric cares, based on ad hoc interventions undertaken by MW to manage obstetric complications in health centers (HCs), has been developed in rural areas. This study aimed to describe this experience and to analyze the achieved results. METHODS: We conducted a cross-sectional, analytical, intervention study based on a review of routine data from all the parturients treated from 2013 to 2015. Data collection took place from 5 to 20 January 2016. Chi-square Test, odds ratios (ORs) and their 95% confidence intervals were calculated. RESULTS: A total of 416 parturients with obstetric complications were treated by zonal MW. The average age of patients was 26.4 years. The median distance travelled to treat parturients was 15 km, with an average intervention period of 21.1 minutes (standard deviation = 7.13 minutes). Dystocias accounted for half (50.7%, CI95%= 45.8-55.6) of treated complications followed by hemorrhage (26.4%, CI95%= 22.3%-31.0%). More than 77% of interventions resulted in local resolution of obstetric complications. Finally, the intervention outcome was subject to the pathology treated (OR=5.88; p < 0.001). CONCLUSION: This strategy was an answer to the shortage of MWs in the perypheral HCs in the health district of Tougan. In this particular context, this intervention could provide an alternative solution to the shortage of human resources for health in rural areas.