Integration of postpartum care into child health and immunization services in Burkina Faso: findings from a cross-sectional study

Yugbaré Belemsaga, Danielle and Goujon, Anne and Bado, Aristide and Kouanda, Seni and Duysburgh, Els and Temmerman, Marleen and Degomme, Olivier (2018) Integration of postpartum care into child health and immunization services in Burkina Faso: findings from a cross-sectional study. Reproductive Health, 15 (1). pp. 1-17. ISSN 1742-4755

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Background: The Missed Opportunities for Maternal and Infant Health (MOMI) project, which aimed at upgrading maternal and infant postpartum care (PPC), implemented a package of interventions including the integration of maternal PPC in infant immunization services in 12 health facilities in Kaya Health district in Burkina Faso from 2013 to 2015. This paper assesses the coverage and the quality of combined mother-infant PPC in reproductive, maternal, newborn and child health services (RMNCH). Methods: We conducted a mixed methods study with cross-sectional surveys before and after the intervention in the Kaya health and demographic surveillance system. On the quantitative side, two household surveys were performed in 2012 ( N = 757) and in 2014 ( N = 754) among mothers within one year postpartum. The analysis examines the result of the intervention by the date of delivery at three key time points in the PPC schedule: the first 48 h, days 6 - 10 and during weeks 6 - 8 and beyond. On the qualitative side, in depth interviews, focus group discussions and observations were conducted in four health facilities in 2012 and 2015. They involved mothers in the postpartum period, facility and community health workers, and other stakeholders. We performed a descriptive analysis and a two-sample test of proportions of the quantitative data. The qualitative data were recorded, transcribed and analysed along the themes relevant for the intervention. Results: The findings show that the WHO guidelines, in terms of content and improvement of maternal PPC, were followed for physical examinations and consultations. They also show a significant increase in the coverage of maternal PPC services from 50% (372/752) before the intervention to 81% (544/672) one year after the start of the intervention. However, more women were assessed at days 6 - 10 than at later visits. Integration of maternal PPC was low, with little improvements in history taking and physical examination of mothers in immunization services. While health workers are polyvalent, difficulties in restructuring and organizing services hindered the integration. Conclusion: Unless a comprehensive strategy of integration within RMNCH services is implemented to address the primary health care challenges within the health system, integration will not yield the desired results.

Item Type: Article
Additional Information: This work was funded by the MOMI project "Missed Opportunities in Maternal and Infant Health: Reducing maternal and newborn mortality and morbidity in the year after childbirth through combined facility and community-based interventions." MOMI has received funding from the European Community Seventh Framework Programme [FP7/2007 - 2013] under grant agreement No 265448. MOMI was a collaborative project between the Institut de Recherche en Sciences de la Santé (Burkina Faso), the International Centre for Reproductive Health - Ghent University (Belgium), the International Centre for Reproductive Health (Kenya), the Parent and Child Initiative of the Kamuzu Central Hospital and Ministry of Health (Malawi), the International Centre for Reproductive Health (Mozambique), the Eduardo Mondlane University (Mozambique), the Medical Faculty of the University of Porto (Portugal), and the University College of London (United Kingdom). DYB was a MOMI project PhD student.
Keywords: Postpartum, Maternal and infant health, Integration of services, Burkina Faso
Version of the Document: Published
Depositing User: ePub Administrator
Date Deposited: 13 Dec 2018 10:16
Last Modified: 13 Dec 2018 10:16
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