Evaluation of a pilot program for task sharing short and long-acting contraceptive methods in Burkina Faso

Abstract

The Family Health Directorate of the Ministry of Health and Background: Marie Stopes Burkina Faso, with implementing partners, Association Burkinabè pour le Bien-être Familial and Equilibres & Populations collaboratively conducted a pilot project in Burkina Faso focused on "increasing access to family planning (FP) services through task-sharing short-and long-acting family planning methods to primary care cadres." Four cadres of providers provided intrauterine devices (IUDs) and implants, while community health workers (CHWs) provided pills and subcutaneous injectables. FHI 360 and the Institut Supérieur des Sciences de la Population evaluated the project's impact on method uptake, client satisfaction, safety, acceptability and the feasibility of task sharing.The evaluation employed FP service statistics on new users and Methods: conducted 425 client exit interviews and 27 in-depth interviews . New FP clients, community representatives, MoH officials, and pilot project-trained FP providers from Dandé and Tougan districts participated in these interviews.Providers, community representatives and government officials all Results: spoke favorably of the pilot project and considered it a boon to women and the communities in which they lived. FP clients were satisfied with their methods and the services they received from their respective providers, and they reported no safety concerns. However, service statistics did not show a clear and steady increase in method uptake for the four methods beyond spikes coinciding with pre-existing free contraceptive weeks.A scale-up plan for 2020-2022 is in place and will Conclusions: purposefully implement sensitization and demand generation activities to improve FP uptake beyond free contraceptive weeks.

Trends in the Use of Reversible Modern Contraceptives in Burkina Faso between 2010 and 2015

“…The lack of significance in interaction terms between place of residence and education suggests that these variables did not undergo significant changes at the national level, and the differences between their categories remained largely unchanged. This stagnant inequality confirms the insufficient These findings are consistent with a recent study that revealed higher unmet contraceptive needs among rural women compared to urban women in Burkina [27]. The persistence of geographical barriers, such as limited access to mobile clinics and inadequate stock at certain locations, may contribute to the continued disparity between urban and rural areas [10].…”

“…Unmet need has been examined using 2010 Demographic and Health Survey data [23], although it does not capture the percentage of women currently at risk of unintended pregnancy and not using contraception [24]. Recent research based on PMA2020 data has primarily focused on specific contraceptive methods [5] [25] [26] [27]. Most previous studies have investigated modern contraceptive use or unmet need among all women, regardless of their current risk of pregnancy.…”

Evidence of intrauterine device insertion by nurses in Primary Health Care: an integrative review

“…From the analysis of studies ( 15 , 24 - 32 ) , three categories emerged: Nurse training to insert an intrauterine device; Nurses’ competency to insert an intrauterine device; and Women’s access to intrauterine devices.…”

“…The findings showed records of IUD insertion by nurses over 40 years ago ( 24 - 25 ) and, since then, different forms of training these professionals to perform the procedure have been documented ( 24 , 27 , 29 , 31 - 32 ) . A study carried out in 1979 described how nurses and midwives were trained to insert and remove IUD, in which each professional needed to insert 20 devices to be considered qualified ( 24 ) .…”

“…IUD insertion safety by nurses is consolidated in the outcomes of the procedure described in the studies, with emphasis on excellent satisfaction among users ( 28 , 32 ) , absence of serious complications after the procedure ( 24 , 32 ) and low percentage of effects undesirable ( 32 ) . It should be noted that there was no significant difference in the outcomes of IUD insertions performed by physicians and nurses ( 25 - 27 ) , even when comparing different variables, such as removal, expulsion, retention and unwanted pregnancy ( 25 ) .…”