Towards reduction of maternal and perinatal mortality in rural Burkina Faso: communities are not empty vessels.

Background: Reducing maternal and perinatal mortality in sub Saharan Africa remains challenging and requires effective and context specific interventions.

Objective: The aims of this paper were to demonstrate the impact of the community mobilisation of the Skilled Care Initiative (SCI) in reducing maternal and perinatal mortality and to describe the concept and implementation in order to guide replication and scaling up.

Designs: A quasi experimental design was used to assess the extent to which the SCI was associated with increased institutional births, maternal and perinatal mortality reduction in an intervention (Ouargaye) versus a comparison (Diapaga) district.

Improving poor women's access to maternity care: Findings from a primary care intervention in Burkina Faso.

To date, there has been little progress in reducing wealth inequities in access to maternity care. This paper describes the results of a maternal health intervention in Burkina Faso that was aimed at increasing access to skilled maternity care by improving availability and quality of maternity care, particularly at primary care health facilities, and promoting its use before, during, and after delivery. Post-intervention data show a large overall increase in use of facility-based maternity care in the intervention district, particularly at primary care facilities, but little change in the comparison district.

Out-of-pocket costs for facility-based maternity care in three African countries.

Unlabelled: OBJECTIVE To estimate out-of-pocket medical expenses to women and families for maternity care at all levels of the health system in Burkina Faso, Kenya and Tanzania. METHODS In a population-based survey in 2003, 6345 women who had given birth in the previous 24 months were interviewed about the costs incurred during childbirth. Three years later, in 2006, an additional 8302 women with recent deliveries were interviewed in the same districts to explore their maternity care-seeking experiences and associated costs.

Methods for evaluating effectiveness and cost-effectiveness of a Skilled Care Initiative in rural Burkina Faso.

Introduction: This paper aims to describe the design, methods and approaches used to assess the effectiveness and cost-effectiveness of the Skilled Care Initiative in reducing pregnancy-related and perinatal mortality in Ouargaye district, Burkina Faso.

Methods: The evaluation used a quasi-experimental design, mixed methods and a composite of tools to compare mortality and severe morbidity (near-miss) of women in reproductive age, perinatal mortality, facility functionality, perceived quality of care, utilisation of maternal health services, and costs borne by families and the health care system for maternal health care in Ouargaye and Diapaga districts. Structured questionnaires and interview guides were developed, pre-tested and piloted prior to the main survey.

Evaluating skilled care at delivery in Burkina Faso: principles and practice.

There are strong expectations of what could be achieved by skilled care at delivery for maternal and newborn survival and health. Meeting these expectations involves the translation of the concepts and principles of skilled attendance into the reality of routine programmes. This process of translation brings to light some of the tensions which lie behind the consensus on the ideal package and particularly the alternative configurations of provider and place necessary in the immediate term.