Women in Burkina Faso have a 1 in 28 chance of death related to maternal causes, with an average birth rate of 6 children per woman and low contraceptive prevalence: only about 16 percent of women use any method at all. Although the country remains committed to improving these numbers, much work remains to be done to reduce total maternal and infant deaths occurring each year. Greater access to quality family planning and reproductive health services will greatly assist in achieving these goals.
E2A assessed the implementation and scale-up of Postabortion care (PAC) programs in four Francophone West African countries, including Burkina Faso. The assessment focused on the family planning component of PAC. Each of the four countries applied a Virtual Fostering Change methodology for the scale-up of PAC programs, beginning in 2008.
The provision of FP within PAC services – a key component of the widely accepted PAC model – has been identified as a high-impact practice which contributes to the use of FP by women who need FP services. While the impact of this practice is known, more evidence is needed about successful approaches to its implementation and sustainable scale-up. The purpose of the assessment conducted by E2A was to identify the core activities undertaken by the four countries to strengthen PAC-FP services at the point of treatment and factors that contributed to – or hindered – success. In addition, the assessment looked at the role the Virtual Fostering Change methodology played in introducing and sustaining FP within PAC services. Virtual Fostering Change was introduced following a regional meeting in 2008 that focused on strengthening the quality and scale-up of PAC services in West Africa. The meeting was sponsored by the US Agency for International Development (USAID) and the World Health Organization, with support and participation from the Implementing Best Practices Initiative, governments, national and international organizations.
Between September 2012 and March 2013, E2A, working with guidance from key government partners in the region, USAID, and participants of the 2008 PAC meeting, collected data from health facilities, including conducting interviews with service providers, reviewing service delivery statistics, and leading focus group discussions. Key government counterparts were interviewed, as were projects that provided technical assistance to the initiative, and E2A conducted a desk review of PAC programs as a complementary feature of the work.
E2A's assessment report of the PAC program in Burkina Faso is referenced below.
Results of the assessments were presented at a regional workshop, held last October in Saly, Senegal. Based on the assessment results, representatives from the four countries, along with others in Francophone West Africa, have made plans to strengthen certain aspects of PAC service delivery over the next year. The assessment provides a useful contribution to understanding what works and does not work in PAC program implementation. E2A is committed to strengthening FP within PAC services and will seek opportunities to apply these programmatic lessons widely.
National PAC Strategy Development
Based on findings from E2A’s assessment and needs identified by stakeholders at the regional meeting, E2A assisted the Government of Burkina Faso with developing a national PAC strategy. The strategy will be incorporated in Burkina Faso’s Road Map to Accelerate Reduction in Maternal and Child Mortality. E2A’s inputs will promote and support expansion of the method mix to enhance choice, promote provision of long-acting and permanent methods, and support development of a community component of PAC and youth-friendly PAC services.
Centers of Excellence
In December 2016, E2A and the Ministry of Health held a training workshop with providers from 20 health facilities in East and Central Plateau. The workshop used adapted versions of the Optimizing Performance and Quality tools used by E2A to train providers in Togo. E2A is now considering how it can support Pathfinder International's Centers of Excellence in Burkina Faso, which mentor providers to expand the number of PAC providers who have core FP/RH competencies. Support may include documentation of the processes and outcomes from the Centers of Excellence to inform institutionalization and scale-up of the model in Burkina Faso.
To strengthen family planning service delivery, Pathfinder, in collaboration with the Ministry of Health and the National Public Health School, is implementing a strategy to build the capacity of six health facilities to be family planning/reproductive health (FP/RH) “Centers of Excellence.” The centers—two each in Ouagadougou, Bobo Diallaso, and Tenkodogo regions —will serve as practicum training sites for FP/RH in-service training and pre-service education. E2A will provide robust documentation of the existing Centers of Excellence to inform scale-up.
E2A will introduce the ExpandNet scale-up approach to enhance scalability by documenting the process and outcomes, including significant changes and lessons learnt from the Centers of Excellence model to improve the practical competencies of midwifery students and the quality of FP/RH service delivery. E2A in collaboration with Pathfinder/Burkina Faso and the Ministry of Health will design, conduct, and document an intervention to assess changes in improved provider counseling competencies. It will also document the impact that job aids with client centered messages have on contraceptive method uptake immediately and after emergency treatment of abortion complications and at the seven-day client follow-up.
Documentation of Program for First-Time Parents
Also in Burkina Faso, Pathfinder International leads a program that addresses the unique sexual and reproductive health needs of childbearing, young women and girls in a region with early childbearing and high risk of poor maternal and child health outcomes. The program includes youth-friendly health services and behavior change activities, builds social networks and cohesion among young childbearing women, and addresses social norms and gender inequality. Through these approaches, the program aims to improve healthy timing and spacing of pregnancy among young women, ages 10 to 24, including first-time parents.
E2A has worked with Pathfinder International to strengthen the monitoring and evaluation component of this work and to document the approach applied to reach first-time parents and its outcomes. A program brief and report document Pathfinder International's programmatic approach in Burkina Faso. This documentation complements E2A’s other activities focused on first-time parents, including: the publication of literature review that provides an overview of the population and evidence of approaches that could be adapted for first-time parents; the convening of sexual and reproductive health experts to discuss a model for reaching first-time parents with essential services; based on input from the experts, the development of an integrated framework program designers can use to develop approaches to reach first-time parents; and the potential documentation of approaches applied by Pathfinder International in other countries to reach first-time parents.
|Lifetime Risk of Maternal Death:||1/28|
|Country Fertility Rate:||6%|
|PRB 2014 World Population Data Sheet|