Evaluation of Adherence of Health-Care Workers to Integrated Management of Childhood Illness Guidelines in the Context of the Free Care Program in Burkina Faso.

To reduce child mortality in children younger than 5 years, Burkina Faso has been offering free care to this population of children since 2016. The free care program is aligned with the Integrated Management of Childhood Illness (IMCI) guidelines. Given that the number of studies that evaluated the competence of health-care workers (HCWs) during the free care program was limited, we assessed the adherence level of HCWs to the IMCI guidelines in the context of free care. This was a secondary data analysis. Data were obtained from a cross-sectional study conducted from July to September 2020 in 40 primary health-care centers and two district hospitals in the Hauts-Bassins region in Burkina Faso. Our analysis included 419 children younger than 5 years old who were consulted according to IMCI guidelines. Data were collected through direct observation using a checklist. The overall score of adherence of HCWs to IMCI guidelines was 57.8% (95% CI, 42.6-73.0). The mean adherence score of the evaluation of danger signs was 71.9% (95% CI, 58.7-85.1). The mean adherence score of following IMCI guidelines was significantly greater in boys (54.2%) compared with girls (44.6%; P < 0.001). Adherence scores of the performance of different IMCI tasks were significantly different across HCW categories. The overall adherence of HCWs to IMCI guidelines in the context of free care was greater than the adherence reported before the implementation of free care in Burkina Faso. However, this assessment needs to be performed nationwide to capture the overall adherence of HCWs to IMCI guidelines in the context of the free care program.

The outbreak of meningitis due to Neisseria meningitidis W135 in 2003 in Burkina Faso and the national response: main lessons learnt.

Among the countries situated in the African meningitis belt, Burkina Faso is usually the one which pays the highest toll to this disease in terms of morbidity and mortality. Until 2002, the causal agent of the epidemic was usually Neisseria meningitidis serogroup A. At the onset of the 2002 epidemic, N. meningitidis W135 was identified as the predominant serogroup by the national reference hospital and the WHO, and this was confirmed by the WHO collaborating centre on meningitis in Oslo, Norway. Due to the nonavailability of an affordable and effective vaccine, the only adequate strategy was proper case management, taking advantage of the sensitivity of the bacteria to the currently used antibiotics. In order to avoid the repetition of such a situation, WHO and GlaxoSmithKline, with the financial support of the Bill and Melinda Gates Foundation, planned and actually realized the production of a trivalent ACW135 vaccine in anticipation of the 2003 epidemic season. In order for the vaccine to be effectively used in the field, it was imperative that various ethical, managerial and technical conditions be fulfilled. The successful use of the trivalent polysaccharide vaccine ACW135 in Burkina Faso during the 2003 outbreak was essentially due to the high level of leadership demonstrated by the national authorities of Burkina Faso, the facilitating role of WHO, the effective coordination of partners and activities, the transparency in the response to the epidemic and the management of the resources.

A combined school- and community-based campaign targeting all school-age children of Burkina Faso against schistosomiasis and soil-transmitted helminthiasis: performance, financial costs and implications for sustainability.

A combined school- and community-based campaign targeting the entire school-age population of Burkina Faso with drugs against schistosomiasis (praziquantel) and soil-transmitted helminthiasis (albendazole) was implemented in 2004-2005. In total, 3,322,564 children from 5 to 15 years of age were treated, equivalent to a 90.8% coverage of the total school-age population of the country. The total costs of the campaign were estimated to be US 1,067,284 dollars, of which 69.4% was spent on the drugs. Delivery costs per child treated were US 0.098 dollar, in the same range as school-based only interventions implemented in other countries; total costs per child treated (including drugs) were US 0.32 dollar. We conclude that a combined school- and community-based strategy is effective in attaining a high coverage among school-age children in countries where school enrolment is low and where primary schools cannot serve as the exclusive drug distribution points. The challenge for Burkina Faso will now be to ensure the sustainability of these disease control activities.