Model delivery system developed by Jhpiego in Burkina Faso results in better health
services to mothers and newborns
The quality of health care services to mothers and their newborns in
Burkina Faso has improved significantly since Jhpiego's Maternal and Neonatal Health (MNH) Program started working there in 1999.
In partnership with international and national organizations, Jhpiego helped develop a model
delivery system aimed at increasing the use of skilled providers during pregnancy, childbirth,
and the postpartum period. Over 40 providers at 13 model sites in the Burkina Faso's
Koupéla district have been trained in the latest evidence-based maternal and newborn
health care practices and now use updated clinical standards for basic and emergency maternal
and neonatal services, infection prevention, family planning, and postabortion care.
Burkina Faso, an arid, landlocked country in West Africa, is one of the
poorest and least developed countries in the world, with high rates of maternal, neonatal
and infant mortality. The goal of the MNH/Burkina Program is to increase survival rates
for mothers and their babies in Burkina and throughout West and Central Africa by
promoting the two most effective interventions: the recognition and treatment of maternal
complications and the presence of skilled providers at birth.
Last March representatives of 12 countries in the region attended a
conference in Ouagadougou, Burkina Faso, where participants shared information on
best practices in maternal and neonatal health and the lessons learned from the
MNH/Burkina program. Now other countries in West and Central Africa are developing
their own maternal and neonatal health action plans based on Burkina's model system.
The MNH Program plans to coordinate the training of skilled providers in the region,
using the training sites and expert trainers already established in Burkina Faso.
At the heart of initiatives to prevent, detect and treat complications
is the concept of focused antenatal care, based on the premise that all pregnant women are
at risk for complications and in need of the same basic services during pregnancy. The
MNH Program's approach focuses on the evidence-based interventions that are appropriate
for individual women, depending on their stage of pregnancy and state of health. During
a pregnant woman's prenatal visits to the health center, skilled providers trained by
the MNH Program can detect and treat any problems early on, initiate preventive measures,
counsel her on nutrition and health during pregnancy, and teach her to prepare for birth,
recognize danger signs, and seek emergency care if complications arise.
The MNH/Burkina Program has also helped providers learn how to manage
maternal emergencies through improvements in facility-based clinical practices. For example,
after training from MNH expert trainers, the surgeon at the Koupéla medical center can
now handle complications and perform caesarean deliveries; before, women with
complications were transferred from the Koupéla facility to the nearest referral
hospital, about an hour away.
In addition, the MNH/Burkina training programs for doctors and midwives
now include instruction on the effective use of the partograph, a tool for monitoring
labor and identifying life-threatening complications. Providers also learn how to use
simple techniques to resuscitate babies after birth, thus saving the lives of many infants.
Since the beginning of the program, antenatal care visits to the 13 model
health facilities have increased substantially: in 2002, 83 percent of women giving birth
had at least four visits, compared to 66 percent in 2000. Deliveries with skilled providers
also rose during that period, from 36 percent to 42 percent. The increase in service
utilization by the women in the district is due to gains in performance improvement at
the facility level, better supervision, competence of service providers, and community
awareness efforts.
Building community coalitions to address maternal and newborn health
issues is an important part of the MNH Program's strategy for improving birth preparedness
and complication readiness (BP/CR). To date, over 150 villages in the district and 600
community members have been involved in social mobilization efforts to improve BP/CR
by increasing the use of skilled providers during pregnancy, childbirth, and the
postpartum period. Last year the MNH/Burkina Program received first prize from the
Global White Ribbon Alliance for outstanding community safe motherhood activities.
The model delivery system also serves as a platform for testing
innovative clinical approaches to maternal health care. For example, a pilot project
is underway in the Koupéla district to implement new interventions for preventing and
controlling malaria during pregnancy.
About Jhpiego
For nearly 40 years, Jhpiego, (pronounced "ja-pie-go"), has empowered front-line health
workers by designing and implementing simple, low-cost, hands-on solutions that
strengthen the delivery of health care services, following the
household-to-hospital continuum of care. We partner with community- to
national-level organizations to build sustainable, local capacity through
advocacy, policy and guidelines development, and quality and performance
improvement approaches.
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