Comparing quality of reproductive health services before and after clinic-strengthening activities: A case study in rural Burkina Faso

Much literature has been written about improving the quality of reproductive health (RH) care at service delivery points (SDPs) because women deserve quality services, and as a means of increasing use of family planning (FP) and other RH services. There are six fundamental dimensions of quality of care: choice of methods, information given to clients, technical competence, interpersonal relations, mechanisms to encourage continuity, and an appropriate constellation of services. Improving these elements is thought to increase client satisfaction, resulting in an increase in contraceptive use and eventually fertility decline. Existing research has not convincingly demonstrated this link between quality of care and client outcomes. Training service providers on FP and communication skills and improving clinic infrastructure/equipment are ways of possibly improving aspects of nearly all elements of quality. An intervention in a rural field research station in Burkina Faso was designed to supply RH training and basic medical equipment to 13 SDPs. This paper details an operations research project that tests the strength of community-based and clinic interventions on RH knowledge, attitudes, and practice, and assesses overall contraceptive prevalence in the area

COVID-19 pandemic in Africa: Is it time for water, sanitation and hygiene to climb up the ladder of global priorities?

The authors would like to thank the authors of the freely-usable images from Unsplash and Pixnio included in the Graphical Abstract: photos by Janice-Haney Carr and Dr. Ray Butler (USCDCP), USCDCP and Crystal Thompsom (USAID) on Pixnio; photos by CDC, UN COVID- 19 response and Raymond Hui on Unsplash.Wewould also like to thank the reviewers for their comments and keen interest in this article.In the current pandemic context, it is necessary to remember the lessons learned from previous outbreaks in Africa, where the incidence of other diseases could rise if most resources are directed to tackle the emergency. Improving the access to water, sanitation and hygiene (WASH) could be a win-win strategy, because the lack of these services not only hampers the implementation of preventive measures against SARS-CoV-2 (e.g. proper handwashing), but it is also connected to high mortality diseases (for example, diarrhoea and lower respiratory infections (LRI)). This study aims to build on the evidence-based link between other LRI andWASH as a proxy for exploring the potential vulnerability of African countries to COVID-19, as well as the role of other socioeconomic variables such as financial sources or demographic factors. The selected methodology combines several machine learning techniques to single out the most representative variables for the analysis, classify the countries according to their capacity to tackle public health emergencies and identify behavioural patterns for each group. Besides, conditional dependences between variables are inferred through a Bayesian network. Results show a strong relationship between low access toWASH services and high LRI mortality rates, and that migrant remittances could significantly improve the access to healthcare and WASH services. However, the role of Official Development Assistance (ODA) in enhancing WASH facilities in the most vulnerable countries cannot be disregarded, but it is unevenly distributed: for each 50–100 US$of ODA per capita, the probability of directing more than 3 US$ toWASH ranges between 48% (Western Africa) and 8% (Central Africa)

Policy solutions based on evidence

French version available in IDRC Digital Library: Ouaga focus, no. 4, 2014 / L'accès à l'eau en zone non lotie : la réalité cachéeThe Ouagadougou Health and Demographic Surveillance (Ouaga-HDSS) selected areas to study problems of the urban poor, and to test innovative programs aiming to promote their well-being. This study focuses on urban populations’ access to water, including distance covered to fetch water. In three informal settlements monitored by the project, one in five households did not have access to an improved water source. Among households supplied through a collective water source such as a stand pipe or borehole, approximately half of the populations surveyed did not have access to basic minimum requirements

Productivity, family planning and reproductive health in Burkina Faso 2013-2014

(1)Quantitative data from a prospective cohort study of 839 pregnant and/or postpartum women who were between seven months gestation and three months postpartum at recruitment. Participants were interviewed three times over a nine month period. The cohort is a population-representative sample of parturient women in the commune of Bobo-Dioulasso, Burkina Faso. Data were collected relating to socio-demographic characteristics; household assets; reproductive history; women’s work and occupation including both income-generating and non-income generating activities; birth and postpartum preparedness; characteristics of the index delivery; contraceptive history and current use; fertility preferences; health-related functioning (ability to carry out usual daily activities); haemoglobin level; mental health measured through the K10 scale; time use diary; household food security scale. (2) qualitative data (transcripts of 56 in-depth interviews and 3 focus group discussions) from a nested cohort of women recruited from within PopDev, and their husband/partners. Key themes discussed in these qualitative data are women’s work, use of family planning, and the factors that facilitated or were challenging during their return to work during the postpartum period. Interviews with policy makers and key stakeholders also conductedOur previous ESRC-funded research in Burkina Faso showed the adverse effects of serious illnesses during pregnancy and the high costs of care on women's lives. The aim of this new project is to gain a detailed understanding of how the arrival of a new baby affects women’s productivity and how family planning and other reproductive health services can help women returning to good health and work. This multi-disciplinary project includes three sub-studies. Sub-study A is a secondary analysis of cross-sectional survey data collected in Burkina Faso from 2001-2006. Sub-study B is a cohort study of women identified in the community during pregnancy and the first trimester after childbirth. Over a period of nine months, women will be interviewed three times about their health, preparations they made for childbirth and the period after childbirth, changes in paid work (or education) and domestic work, fertility intention and contraceptive needs. Interviewers will measure women's blood pressure and whether they have anaemia. In sub-study C, qualitative methods will document how women and their family make decisions on work, childbirth and family planning. Sub-study C will re-interview a sub-sample of cohort women, observe some of them in their daily activities, and interview men, policy makers as well as health care providers. </p

Evaluation de la prise en charge de la maternité sans risque et de la survie de l\u27enfant au niveau communautaire de Bazéga

Cette étude fournit des informations sur les actions actuelles aux niveaux communautaire et individuel en matière de survie de l’enfant et de maternité sans risque. Les prestataires et le Ministère de la Santé, ainsi que tout intervenant, pourront par conséquent utiliser les résultats pour l’élaboration d’interventions ou actions appropriées. C’est une étape préalable au développement de stratégies idoines en matière de survie de l’enfant et maternité sans risque dans le cadre du Laboratoire de santé communautaire (LSC). Aussi bien en ville qu’en campagne, la nécessité d’avoir une meilleure compréhension de la perception, par les communautés et les prestataires communautaires, des signes précurseurs de risque pendant la grossesse, l’accouchement et le post-partum, l’itinéraire thérapeutique ou la prise en charge médicale ou communautaire des femmes enceintes et accouchées ainsi que les activités en matière de survie de l’enfant, s’impose, surtout quand on veut élaborer des stratégies culturellement acceptables. C’est dans cet esprit qu’il a été commandité cette étude qualitative pour contribuer à l’élaboration d’interventions communautaires appropriées en matière de survie de l’enfant et de maternité sans risque dans la zone du LSC. --- This study provides information on current actions at community and individual levels in child survival and safe motherhood. Providers and the Ministry of Health, as well as any stakeholders, may therefore use the results to develop appropriate interventions or actions. This is a preliminary step to the development of appropriate strategies for child survival and safe motherhood within the framework of the Community Health Laboratory (LSC). Both in the city and in the countryside, the need to have a better understanding of the perception, by communities and community providers, of the warning signs of risk during pregnancy, childbirth and postpartum, the route therapy or treatment medical or community services for pregnant and postpartum women, as well as child survival activities, is essential, especially when it comes to developing culturally acceptable strategies. It is in this spirit that this qualitative study was commissioned to contribute to the development of appropriate community-based child survival and safe motherhood interventions in the LSC area

Perception et comportement des hommes, des femmes, et des prestataires des services en matiére des morbidités relatives a la santé de la reproduction

Cette étude fournit des informations sur le vocabulaire utilisé pour désigner les infections pelviennes et génitales et les infections sexuellement transmissibles (IST). La présente étude a nécessité l’utilisation de quatre approches méthodologiques en recherche qualitative pour la collecte et l’analyse des données dans les zones A et B du Laboratoire de santé communautaire (LSC). Ce sont les groupes de discussions dirigées, les entretiens individuels approfondis et le listage libre et le tri par piles. Au niveau de la communauté, cinq groupes cibles étaient concernés : les filles célibataires de moins de 25 ans, les femmes mariées de 25 à 39 ans, les femmes de plus de 40 ans, les hommes célibataires de moins de 25 ans, et les hommes mariés de 25 à 39 ans. La présente étude constitue un outil de travail approprié tant pour les décideurs que pour les prestataires (clinique ou communautaire). Les efforts sont à poursuivre au niveau de la communauté pour une meilleure perception et la distillation de la bonne information sur les causes et conséquences des IST en général et du SIDA en particulier. L’urgence de poursuivre la sensibilisation pour tous les groupes cibles s’est manifestée tout au long de l’étude. Il est suggéré que la réflexion soit mise en place sur un programme de services de santé de la reproduction qui leur est destiné en même temps qu’aux garçons en milieu rural et semi-rural. --- This study provides information on the vocabulary used to refer to pelvic and genital infections and sexually transmitted infections (STIs). This study required the use of four methodological approaches in qualitative research for the collection and analysis of data in Zones A and B of the Community Health Lab (LSC). These are focus groups, in-depth, individual interviews, and free listing and stack sorting. At the community level, five target groups were concerned: single girls under 25, married women between 25 and 39, women over 40, single men under 25, and men married from 25 to 39 years old. This study is an appropriate working tool for both decision-makers and providers (clinical or community). Efforts should continue at the community level for a better perception and the distillation of good information on the causes and consequences of STIs in general and AIDS in particular. The urgency to continue raising awareness for all target groups was evident throughout the study. It is suggested that reflection be put in place on a program of reproductive health services intended for them at the same time as for boys in rural and semi-rural areas