From evaluating a Skilled Care Initiative in rural Burkina Faso to policy implications for safe motherhood in Africa

Authors


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    Immpact Burkina Evaluation Study Group:
    Steering Committee: Peter Byass, Vincent De Brouwere, Nicolas Meda, Sennen Hounton; Scientific leadership: Wendy Graham, Cynthia Stanton, Carine Ronsmans, Véronique Filippi, Tim Ensor, David Newlands, Issiaka Sombié, Banyana Madi, Glyn Chapman; Technical assistance: Dominique Dubourg, Laura Ternent, Edward Fottrell, Axel Emmelin, Prosper Djiguemde, Drissa Kabore, Pierre Ilboudo; Management and logistics: Abdoulaye Traore, Edgar Diboulo; Household survey leadership: Moctar Ouedraogo, Agnan R Ouedraogo, Bernard Dembele, Oumar Z Ouedraogo, Patricia M N Bantoro, Yaya Tall, Régis Bingoure, A Pascal Ziba, Guetwendé Sawadogo, Romaric Zombre, Pascal Ilboudo, Moumouni Ouedraogo, Jean Guy Hyacinthe Kafando, Dialinli Lompo, Youssouf Sawadogo, Boubacar Thiombiano, Bapougouni Yonli, Victor Thiombiano, Ibrahim Bruno Couldiati, Ounteni Ouoba, Yalihana Alima Lompo, Moussa Kano, Frédéric Y Thiombiano, Foldia O Thiombiano; Health facility survey leadership: Mamadou Barro, Danielle Belemsaga, Thomas Ouedraogo, Cecile Tamini, Pascal Nitiema, Blanche Zougrana; Qualitative survey leadership: Maurice Yaogo, Telesphore Some, Melanie Akoum, Georgette Ouédraogo, Perpétue Ouédraogo, Ousseyni Ouédraogo, Kibsbila Kouela, Irène Lompo, Clément Lankouandé; Data management team: Alphonse Kpozehoeun, Ibrahima Diallo, Henri Somé, Alain Somda, Olivier Segeda, Alexandre Yugbare, Roséline Somé, Breiman Djibo, Charlemagne Bambara, Marc Koné, Emilie Barro, Nadine Ouedraogo, Florence Kangoye.

Corresponding Author Dr Nicolas Meda, Centre Muraz, Immpact Project, PO Box 298 Bobo-Dioulasso, Burkina Faso. Tel.: +226 20 97 50 32; Fax: +226 20 97 01 77; E-mail: nmeda.muraz@fasonet.bf

Summary

Evaluation findings from a particular setting need to be generalized into policy implications if they are to find widespread use. Skilled attendance at delivery is widely regarded as one of the most important intervention strategies for safe motherhood in low-resource settings, particularly in Africa, but implementations of such strategies are often not rigorously evaluated or interpreted into future policy. Initiative for Maternal Mortality Programme Assessment (Immpact) has applied a package of research-based monitoring and evaluation tools to assess the Family Care International Skilled Care Initiative in Ouargaye District, Burkina Faso. This evaluation research aimed to generate reliable, evidence-based policies for accelerating safe motherhood programmes in Burkina Faso and elsewhere in Africa. Five policy priorities were identified as representing real chances of improving the safety of motherhood: (1) enhancing national coverage of delivery by professionally skilled attendants; (2) to provide a network of 24-h basic emergency obstetric care within 5 km; (3) to have an effective referral system, equipped and resourced to undertake a reasonable number of Caesarean sections; (4) to promote community mobilization activities as a lever to increasing delivery care utilization; and (5) to implement strategies to remove financial barriers to delivery care. To meet Millennium Development Goal five by 2015, both supply and demand side constraints on the provision of quality maternity care have to be addressed, which in turn need greater political commitment and funding.

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