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

Danielle Yugbaré Belemsaga, Anne Goujon, Aristide Bado, Seni Kouanda, Els Duysburgh, Marleen Temmerman, Olivier Degomme

Publication: Scientific journalJournal articlepeer-review

Abstract

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.
Original languageEnglish
Pages (from-to)1-17
JournalReproductive Health
Volume15
Issue number1
DOIs
Publication statusPublished - 2018
Externally publishedYes

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