Since 2018, the Evidence to Action (E2A) Project has partnered with Burkina Faso’s Ministry of Health to strengthen critical reproductive health and voluntary family planning services. Below, Dr. André Yoland Ky—former Director of Family Health and a valued collaborator—shares his firsthand perspective on this unique partnership and why it can serve as a model for future programs.
What makes a partnership effective? When I think about our Ministry of Health’s collaboration with the E2A project, a number of things stand out. I believe it is important to reflect on the strengths of our partnership, as they may provide a roadmap forward. All are fundamental for effective implementation and, importantly, for strengthening government ownership and facilitating sustainability after a project like E2A ends.
Some of the things I’m referring to here are…
✔ E2A’s participatory approach—conducting joint needs assessment, planning with the field actors, and establishing an accountability mechanism within my Department of Family Health for regular consultation and coordination of monitoring project activities.
✔ Enhanced communication between various implementing actors.
✔ Documentation of good practices to inform our decision making about what comes next.
Together, we made progress at the national level, where the Ministry designated E2A as a member of the performance monitoring committee of its National Family Planning Acceleration Plan. At the decentralized level, E2A also supported processes to generate demand for family planning, build capacity for human resources, and close gaps between communities and health facilities.
At every level, our work with E2A stemmed from our shared commitment and a focus on people:
People in communities and facilities
To address the factors that limit women and girls from using contraception, Burkina Faso’s 2017-2020 costed implementation plan identified “National Family Planning Weeks” as a key strategy in increasing access to services. E2A provided valuable support for this important initiative, with a focus on adolescents and youth—a priority target for our government.
E2A also initiated the use of “3-strain referral tickets” making it possible to effectively monitor the referral and counter-referral of family planning clients—both by community-based health workers and facility-based providers. This was useful in several ways. It improved the entire referral process, and thus client follow-up. It enhanced the continuity of services making it possible to improve the retention of voluntary family planning clients. Ultimately, this new process also improved quality of care by giving family planning services a humanizing dimension—more adapted to and focused on the needs of clients and building clients’ confidence.
As a result, we were able to increase demand for and consistent use of reproductive health services in general and family planning in particular.
Photo courtesy of Tagaza Djibo for Pathfinder International.
People with unique and urgent needs
Through our partnership with E2A, we also made significant gains in bringing much-needed attention and health care to Burkina Faso’s young first-time parents. I am talking about an underserved population of young people at a pivotal period of transition in their lives.
Indeed, these young first-time parents are called upon to assume responsibilities within their families and society. And they sometimes face the judgment and stigma of society and the community at a time when they need its support and guidance the most. These young parents are also, for the first time, called upon to assume new responsibilities related to their partners and their newborns—whose survival and future depends on them.
I am convinced it is important to reach this population of young first-time parents with a targeted set of interventions at both community and health facility levels. What excited me most about E2A’s approach to working with first-time parents is that it features:
⦁ A focus on couples—both young mothers and their partners.
⦁ The involvement of social, family, and community leaders, like mothers-in-law, who are often forgotten determinants in our health interventions, even though their roles are very important in the process of social and behavior change.
⦁ A comprehensive package of topics addressed, which are part of a continuum of integrated care that requires making quality services available upstream.
You can learn more about this first-time parent program, including the various communications channels and monitoring mechanisms E2A introduced, HERE.
People who deliver health care
Skilled and competent human resources are the first and most essential resources of any system, not only in the health system. Provider training, both basic and in-service, is fundamental. In a context of limited resources with ever-increasing needs, innovation deserves to be favored.
The Ministry of Health in Burkina Faso is invested in enhancing human resources approaches—to better serve clients. E2A supported our effort by piloting the on-site training of providers.
On-site training allows us to train many more providers, saving time and money. It also has the advantage of enabling providers to be trained in real situations—in their usual work environment. This is fundamental because it allows providers to increase their knowledge of the site and to adapt the content of the training to their real-life working conditions. Thanks to E2A, the importance of this approach has been clearly demonstrated. And it is currently being implemented in other regions/districts for other interventions and other health areas. The expected logical next step is to scale up this approach at the national level (more on that in a moment).
Photo courtesy of Tagaza Djibo for Pathfinder International.
People who will carry progress forward
E2A showed particular interest in providing direct support to our Department of Family Health within the Ministry. This included technical support to strengthen joint supervision as well as enhancements to facilities that increased the safety, motivation, and productivity of staff. These enhancements will ultimately increase the department’s visibility among partners and stakeholders and contribute significantly to improving its performance results.
Reflecting on this partnership and my tenure as Director of Family Health, there are a few things I would most like to see next. I recognize that the E2A project is ending this year, but the good work we have done together can and should continue. It will take strong national party involvement to empower regional and district actors who can own the interventions. This is the path toward scaling up these proven programs to the national level.
This is the formula for creating lasting change for the people of Burkina Faso.
For more insight into E2A’s work with first-time parents in Burkina Faso, read the brief.