An exploratory analysis of the regionalization policy for the recruitment of health workers in Burkina Faso

BACKGROUND: Health personnel retention in remote areas is a key health systems issue wordwide. To deal with this issue, since 2002 the government of Burkina Faso has implemented a staff retention policy, the regionalized health personnel recruitment policy, aimed at front-line workers such as nurses, midwives, and birth attendants. This study aimed to describe the policy’s development, formulation, and implementation process for the regionalization of health worker recruitment in Burkina Faso. METHODS: We conducted a qualitative study. The unit of analysis is a single case study with several levels of analysis. This study was conducted in three remote areas in Burkina Faso for the implementation portion, and at the central level for the development portion. Indepth interviews were conducted with Ministry of Health officials in charge of human resources, regional directors, regional human resource managers, district chief medical officers, and health workers at primary health centres. In total, 46 indepth interviews were conducted (February 3 - March 16, 2011). RESULTS: Development The idea for this policy emerged after finding a highly uneven distribution of health personnel across urban and rural areas, the availability of a large number of health officers in the labour market, and the opportunity given to the Ministry of Health by the government to recruit personnel through a specific budget allocation. Formulation The formulation consisted of a call for job applications from the Ministry of Health, which indicates the number of available posts by region. The respondents interviewed unanimously acknowledged the lack of documents governing the status of this new personnel category. Implementation During the initial years of implementation (2002-2003), this policy was limited to recruiting health workers for the regions with no possibility of transfer. The possibility of job-for-job exchange was then approved for a certain time, then cancelled. Starting in 2005, a departure condition was added. Now, regionalized health workers can leave the regions after undergoing a competitive selection process. CONCLUSION: The policy was characterized by the absence of written directives and by targeting only one category of personnel. Moreover, there was no associated incentive—financial or otherwise—which poses the question of long-term viability

Exposure to conditions of high concentrations of indoor air pollutants and prevalence of ARIs in children under 5 years of age, in Ouagadougou/Burkina Faso

The objective was to highlight effects of exposure to high concentrations of PM2.5 (emitted during cooking) on the prevalence of acute respiratory infections (ARI) in children under 5 years of age. Results showed that the use of biomass in indoor kitchens in residential buildings in Uganda was linked to the occurrence of ARI in children. Living in a house with several bedrooms was a protective factor. Fine particulate matter (PM2.5) is an air pollutant which can affect people's health when levels are high

Impact of mobile phone intervention on intermittent preventive treatment of malaria during pregnancy in Burkina Faso : A pragmatic randomized trial.

PURPOSE: Intermittent preventive treatment of malaria with sulphadoxine-pyrimethamine for pregnant women (IPTp-SP) coverage remains far below the desirable goal of at least three doses before delivery. This study evaluates an innovative intervention using mobile phones as a means of increasing coverage for the third dose of IPTp-SP. METHODS: This study in Burkina Faso was designed as an open-label, pragmatic, two-arm, randomised trial. Pregnant women who attended antenatal clinic (ANC) visits were included at their first ANC visit and followed until delivery. The intervention was built around the use of mobile phones as means ensuring direct tracking of pregnant women. RESULTS: Two hundred and forty-eight (248) pregnant women were included in the study. The proportion of women who received at least three doses of IPTp-SP was 54.6 %. In the intervention group, 54.1 % of women received at least three doses of IPTp-SP versus 55.1 % in the control group, a non-significant difference (adjusted odds ratio "aOR", 0.86 ; 95 % confidence interval "95 % CI", 0.49-1.51). Women in the intervention group were more likely to carry out their ANC visits in a timely manner than those in the control group (aOR, 3.21 ; 95 % CI, 1.91-5.39). CONCLUSION: While mobile phone intervention did not increase the proportion of women receiving three doses of IPTp-SP, it did help to increase the proportion of timely ANC visits. TRIAL REGISTRATION: PACTR202106905150440

Evaluation de la performance du système d’information hospitalier du Centre Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Burkina Faso

L’information sanitaire est un des six piliers du système de santé. Elle est nécessaire surtout pour la planification sanitaire et la prise de décision dans le secteur de la santé. Mais face au constat d’insuffisance de la qualité des données, de l’utilisation de l’information et du processus des Systèmes d’Information Hospitalier (SIH) des pays du sud notamment au Burkina Faso, notre étude se propose d’apporter une contribution par une évaluation de la performance du SIH dans un hôpital de troisième niveau en utilisant le cadre conceptuel de Performance of Routine Information System Management (PRISM). Celui-ci apprécie le SIH à partir de sa performance en s’appuyant sur la qualité des données et l’utilisation de l’information. Notre population d’étude était constituée par l’ensemble des unités de soins et le service de planification et de l’information hospitalière. A l’intérieur de chaque service, les collecteurs, les utilisateurs, les gestionnaires de données ont été enquêtés ainsi que les décideurs au niveau de la direction de l’hôpital. Ce sont les acteurs essentiels impliqués dans la gestion du SIH au niveau des différentes unités de soins des services cliniques et du service en charge de l’information hospitalière de la direction générale du Centre Hospitalier Yalgado Ouedraogo (CHU-YO). Il s’est agi d’une enquête transversale avec un devis mixte séquentiel explicatif (une approche quantitative suivi d’une approche qualitative) qui a consisté en une évaluation de la qualité des données, de l’utilisation de l’information, de la promotion de la culture de l’information, du processus et des déterminants techniques au CHU-YO. Le PRISM nous a servi de cadre conceptuel de cette évaluation. L’ensemble des unités de soins (US) ainsi que le service de planification et de l’information hospitalière (SPIH) ont été enquêtés. Tous les Surveillants d’Unité de Soins (SUS) chargés de la collecte et 90,77 % (n = 65) des utilisateurs de données (chef de service et SUS) au sein des US de services cliniques et les gestionnaires au niveau du SPIH ont été interrogés. Les entretiens semi-directifs ont été réalisés avec 8 décideurs du CHU-YO au niveau de la direction générale. La qualité des données : la complétude des rapports mensuels (77 %), la promptitude dans la transmission à temps de ces rapports (53,7 %) et l’indice de précision des données (22,4 %) étaient faibles au niveau des US des services cliniques. L’utilisation de l’information pour la prise de décision et le plaidoyer ainsi que la promotion de la culture de l’information étaient également à des niveaux bas avec respectivement 11 % de taux moyen d’utilisation de l’information et 17,5 % pour la promotion de la culture d’utilisation de l’information. En outre l’analyse du processus et des déterminants techniques du SIH ont montré qu’en dehors de la disponibilité des registres et de la facilité d’utilisation des formulaires des rapports mensuels, les autres composantes étaient inexistantes (0,0 %). L’évaluation a montré que le système information hospitalier actuellement en place au CHU-YO présente une faible performance dans ces différentes dimensions. Par conséquent, il devra être renforcé à partir d’actions à même d’améliorer sa performance.Mots-clés : information hospitalière, qualité, PRISM, Burkina Faso

Inadequate childcare practices as a determinant of long term malnutrition in 6-23 months old children from a rural district of Burkina Faso.

info:eu-repo/semantics/publishe

Prise en charge de la malnutrition aiguë sévère dans un centre de réhabilitation et d'éducation nutritionnelle urbain au Burkina Faso

Background: Management of acute severe malnutrition greatly contributes to the reduction of childhood mortality rate. In developing countries, where malnutrition is common, number of acute severe malnutrition cases exceeds inpatient treatment capacity. Recent success of community-based therapeutic care put back on agenda the management of acute severe malnutrition. We analysed key issues of inpatient management of severe malnutrition to suggest appropriate global approach. Methods: Data of 1322 malnourished children, admitted in an urban nutritional rehabilitation center, in Burkina Faso, from 1999 to 2003 were analyzed. The nutritional status was assessed using anthropometrics indexes. Association between mortality and variables was measured by relative risks. Kaplan-Meier survival curves and Cox model were used. Results: From the 1322 hospitalized children, 8.5% dropped out. Daily weight gain was 10.18 (± 7.05) g/kg/d. Among hospitalized malnourished children, 16% died. Patients were at high risk of early death, as 80% of deaths occurred during the first week. The risk of dying was highest among the severely malnourished: weight-for-heigh < -4 standard deviation (SD), RR = 2.55 P < 0,001; low MUAC-for-age, RR = 2.05 P < 0.001. Kaplan-Meier survival curves and Cox model showed that the variables most strongly associated with mortality were weight-for-height and MUAC-for-age. Among children discharged from the nutritional rehabilitation centre, 10.9% had weight-for-height < -3 SD. Conclusion: The nutrition rehabilitation centre is confronted with extremely ill children with high risk of death. There is need to support those units for appropriate management of acute severe malnutrition. It is also important to implement community-based therapeutic care for management of children still malnourished at discharge from nutritional rehabilitation centre. These programs will contribute to reduce mortality rate and number of severely malnourished children attending inpatient nutrition rehabilitation centers, by prevention and early management. © 2007 Elsevier Masson SAS. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Etude de la couverture de la prise en charge de la malnutrition aiguë sévère dans le district sanitaire de Kongoussi au Burkina Faso

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Utilisation des médicaments essentiels génériques par le personnel hospitalier: le cas du CHU Yalgado Ouédraogo (Burkina Faso).

With the institution of the primary health care strategy in 1978 and the devaluation of the CFA franc in 1994 the French-speaking countries of Africa are striving to encourage the prescription of generic essential drugs. However, their prescription rates continue to remain low in these countries, especially in the major hospitals. The aim of this study was thus to determine how prescribers at the national hospital in Ouagadougou were informed about genetric drugs and to analyse their attitudes and practices with a view to elucidating the barriers to a more widespread use of generic essential drugs in hospital practice. The study consisted of a survey of all of the qualified prescribers (n=194) at Yalgado Ouedraogo University Hospital Centre in 1998. Thirty refused to participate and 35 questionnaires were discarded because they were poorly filled out. So, the responses of 129 (66.5%) prescribers in all were analysed. More than 80% (106/129) of the prescribers were aware of the existence of generic drugs in the hospital, but only 24.8% of them considered generics to have the same efficacy as their corresponding proprietary drugs. However, 64.3% of the prescribers felt that there was a place for generic drugs in a last-resort echelon of medical care, such as the national hospital in Ouagadougou, and 85.3 % were willing to prescribe them for their patients because of their low cost. The analysis of the data and the responses to the open questions show that the main conditions that would boost the prescription of generic essential drugs by hospital staff are as follows: generic essential drugs available in appropriate dosage forms and of guaranteed quality; appropriate basic training starting in medical and nursing schools; providing the prescribers with information and further education about generic drugs; and better dispensing of these drugs by the hospital's central pharmacy.English AbstractJournal ArticleResearch Support, Non-U.S. Gov'tinfo:eu-repo/semantics/publishe