Development of Monitoring and Evaluation Systems in Four National Programs Addressing Mother and Child Health in Cote d'Ivoire: Qualitative Analysis of the Emergence and Formulation Process.

Background: Monitoring and evaluation were introduced into the management of national health programs to ensure that results were attained, and that donors' funds were used transparently. This study aims to describe the process of the emergence and formulation of monitoring and evaluation (M&E) systems in national programs addressing maternal and child health in Cote d'Ivoire. Methods: We conducted a multilevel case study combining a qualitative investigation and a literature review. This study took place in the city of Abidjan, where in-depth interviews were conducted with twenty-four (24) former officials who served at the central level of the health system and with six (06) employees from the technical and financial partners' agencies. A total of 31 interviews were conducted from January 10 to April 20, 2020. Data analysis was conducted according to the Kingdon conceptual framework modified by Lemieux and adapted by Ridde. Results: The introduction of M&E in national health programs was due to the will of the technical and financial partners and the political and technical decision-makers at the central level of the national health system, who were concerned with accountability and convincing results in these programs. However, its formulation through a top-down approach was sketchy and lacked content to guide its implementation and future evaluation in the absence of national expertise in M&E. Conclusion: The emergence of M&E systems in national health programs was originally endogenous and exogenous but strongly recommended by donors. Its formulation in the context of limited national expertise was marked by the absence of standards and guidelines that could codify the development of robust M&E systems.

Using CFIR framework for understanding barriers and facilitators to implementation of community tuberculosis program in Burkina Faso.

Introduction: In 2020, there were nearly 9.9 million new Tuberculosis cases and 1.3 million deaths, with about 95% occurring in developing nations. Burkina Faso implemented a community Tuberculosis program, involving Civil Society Organizations, to increase screening and improve treatment outcomes. Therefore, this study aims to identify the factors influencing the implementation of community interventions involving these organizations in the fight against TB in Burkina Faso. Method: This qualitative study conducted semi-structured key informant interviews with a purposive sample of health providers from the ministry of health and community health workers. We used framework (the consolidated framework for implementation research was used method to identify barriers and facilitators to implementation of community tuberculosis program in Burkina Faso. Results: A total of 23 interviews were conducted. The results of this research shed light on several key factors that either contributed to or hindered the program's success. Among the facilitating factors, we identified close collaboration between national and international stakeholders, as well as remarkable program flexibility to adapt to local conditions. Furthermore, continuous training and support for community health workers proved crucial for the program's implementation. However, significant challenges were also unveiled. These challenges encompassed insufficient financial resources, difficulties related to the recruitment and management of civil society associations, and issues regarding program ownership at the peripheral level. Additionally, irregular payments to community health workers had a detrimental impact on their motivation and commitment. Conclusions: Our study conducted a comprehensive examination of the obstacles and facilitators encountered in the implementation of a community-based tuberculosis control program in Burkina Faso. The results of this research shed light on several key factors that either contributed to or hindered the success implementation of program. Measures should be taken to mobilize national resources, strengthen the capacities of associations, and promote local ownership of the program. Special attention should also be given to improving financial management and resolving issues related to the recruitment and compensation of community health workers. For such community-based tuberculosis programs to succeed in Burkina Faso and in similar context it is essential to address these obstacles and facilitators.

Comment prendre le pas sur le coronavirus dans un pays en développement: questions et actions au Burkina Faso.

Le monde entier est touché par un bouleversement sans précédent, crée par un virus incontrôlable et qui a pris le pas sur les théories scientifiques les plus élaborées. Les grandes puissances peinent à empêcher l'hécatombe dans les effectifs de leurs citoyens infectés, en dépit de toutes les avancées scientifiques et technologiques. Les pays à ressources limitées et dans lesquels vivent des populations parmi les plus vulnérables apparaissent comme les cibles sur lesquelles le virus est susceptible de faire le maximum de dégâts. Cette note discute des approches stratégiques, propose des mesures politiques et suggère des recommandations. La capacité de dépistage/diagnostic, les mesures de protection et d'assainissement, la communication et l'implication de la communauté seraient des priorités de riposte.