Effectiveness of the Skilled Care Initiative in Burkina Faso

Background: IMMPACT is a global safe motherhood research initiative. To generate evidence on cost-effective safe motherhood strategies, IMMPACT selected a number of programs across a mix of geographical contexts. In Burkina Faso, the evaluation focused on the effectiveness of the FCI's Skilled Care Initiative (SCI), implemented in Ouargaye district.

Materials and Methods: A retrospective household census, facility surveys and qualitative studies were carried out from January to July 2006 to assess changes from 2001 to 2005 between intervention and control districts with respect to maternal and perinatal outcomes, facility functionality, perceived quality of care, utilization of maternal health services, and costs.

Results: Preliminary results show no significant difference of maternal mortality and perinatal mortality between intervention and comparison districts. There were, however, considerable within-district and between-district variations in health facility functionality index, poverty quintiles. These variations highlight the need for multivariate analyses when evaluating such complex interventions. The rates of institutional deliveries and met obstetric need generally increased over time, particularly in the intervention area. The health facility functionality index, derived from principal component analysis of five key variables (personnel, drugs, other recurrent items, infrastructure, and vehicles) appears to be correlated with skilled attendance rates. The main driving costs were personnel and buildings.

Conclusions: Preliminary results indicate that the skilled care package has beneficial effects on key indicators, such as facility functionality and skilled care at delivery.