Évaluation de l'offre de soins en situation d'urgence basée sur la mise en place des postes de santé avancés dans la ville de Djibo, Burkina Faso, avril 2022.

INTRODUCTION: The town of Djibo in Burkina Faso has been facing a security and humanitarian crisis since 2015. The internally displaced populations who have taken refuge there have several needs, including health care. The establishment of advanced health posts is part of the health-nutrition service delivery strategy adopted to address these needs. We evaluated the contribution of these advanced health posts in terms of availability, access to care, and beneficiary satisfaction. METHODOLOGY: We conducted a mixed descriptive and analytical cross-sectional study from May 1, 2021 to January 30, 2022 on the host population, internally displaced people, health workers, and selected health facilities in Djibo. It involved 422 people for the quantitative component. The quantitative data, including those from 2016 to 2020, were analyzed using Epi Info software, version 7.2.3.1, and completed by a qualitative component. RESULTS: Of the nine peripheral structures studied, seven were advanced health posts offering basic care such as prenatal and postnatal consultations, infant monitoring, and vaccination. Nutritional interventions were inadequate in some of these advanced health posts. Geographic access was satisfactory, but financial access was not. CONCLUSION: The strategy made it possible to meet basic health care needs in this crisis context, but financial access must be improved.

Task-Shifting Immunization Activities to Community Health Workers: A Mixed-Method Cross-Sectional Study in Sahel Region, Burkina Faso.

INTRODUCTION: Faced with the frequent disruptions to the health care system and provision of immunization services caused by terrorist attacks that began in 2015, the Sahel region in Burkina Faso initiated resilience strategies, including the task-shifting of immunization activities to community health workers (CHWs). This strategy was designed to involve more CHWs in the vaccination delivery process and ultimately to improve the performance of the health care system. STRATEGY DEVELOPMENT AND IMPLEMENTATION: The task-shifting strategy began as a pilot in Djibo health district in 2019 and then extended to all 4 districts of the Sahel region. CHWs included both personnel recruited through the Ministry of Health and Public Hygiene processes at the national level and other community members who support the operation of health facilities. They were trained on standardized immunization modules and provided with vaccines by functional health facilities teams. Implementation initiated with the administration of oral antigens by CHWs. Subsequently, their service delivery was expanded to include injectable vaccines in the context of the worsening terrorist attacks and the urgent need to protect the health of local populations affected by the security and humanitarian crisis. STRATEGY EVALUATION: The intervention was evaluated through an internal programmatic review conducted as a descriptive cross-sectional study implemented from August 1 to October 28, 2022, in the Sahel region, including a survey in Dori health district. CHWs involved in implementing the strategy were considered for interviews. Performance indicators for all antigens have shown an upward trend since the strategy's inception in 2019. CONCLUSION: The task-shifting of immunization activities to CHWs has been implemented successfully in a region seriously affected by terrorism-related insecurity. It holds the promise of maintaining or even improving performance if institutionalized and scaled up while improving the monitoring of adverse events following immunization by the CHWs.