Accelerate Use and Access to Quality Family Planning in Burkina Faso's
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Evidence to Action for Strengthened Family Planning and Reproductive Health Services for Women and Girls Accelerate Use and Access to Quality Family Planning in Burkina Faso’s Resilience Zone Final Report September 2020 About E2A The Evidence to Action Project (E2A) is the US Agency for International Development’s (USAID) global flagship for strengthening family planning and reproductive health service delivery. The project aims to address the reproductive healthcare needs of girls, women, and underserved communities around the world by increasing support, building evidence, and leading the scale-up of best practices that improve family planning services. A Cooperative Agreement awarded in September 2011, E2A will continue until September 2020. E2A is led by Pathfinder International in partnership with ExpandNet, IntraHealth International, Management Sciences for Health, and PATH. Contact Information E2A Project 1015 15th Street NW Suite 1100 Washington, DC 20005 Tel. 202-775-1977 Fax 202-775-1988 www.e2aproject.org This publication was made possible through support provided by the Office of Population and Reproductive Health, Bureau for Global Health, U.S. Agency for International Development, under the terms of Award No. AID-OAA-A-11-00024. The opinions expressed herein are those of the author(s) and do not necessarily reflect the views of the U.S. Agency for International Development. 2 Acronyms ACF Action Contre la Faim ANJE Alimentation du Nourrisson et du Jeune Enfant CDG Community discussion groups CHW Community Health Worker CMA Centre Médical avec Antenne chirurgicale CPR Contraceptive prevalence rate CSC Community Score Card CSD Conseil de Sante de District CTRS Comité Technique Régional de Santé CYP Couple year protection DHC District Health Council DRS Regional health directorate ECD Equipe Cadre de District/District Management Team E2A Evidence to Action FP Family planning GASPA Groupe d’Apprentissage et de Suivi des Pratiques d’ANJE HC Health center ICP Infirmier Chef de Poste IDP Internally Displaced Persons IUD Intrauterine Device LAM Long acting methods M&E Monitoring and evaluation MCD Medecin Chef de District MNCH Maternal, Newborn, and Child Health MoH Ministry of Health NFPAP National Family Planning Acceleration Plan NGO Non-governmental organization NHDP National Health Development Plan NPESD National Plan for Economic and Social Development PP Post-partum RISE Resilience in the Sahel-Enhanced SMA Social Marketing Agent SNIS Système nationald’information sanitaire / national health information system RH Reproductive health 3 Acknowledgements The E2A Project gratefully acknowledges the generous support of USAID and the Burkina Faso mission. Special thanks are due to the heads of the regional health directorates of the Center North and East Regions, to the Médecins Chefs de District (MCDs) of the districts of Kaya, Barsalogho, Tougouri, Bogandé and Manni, to the Infirmiers Chefs de Poste (ICPs) and the Community Health Workers (CHWs) working in the health areas of the various project-supported health facilities, and to the mayors of the various communes. It is our sincere hope that the work started on this project will continue and improve the health and wellbeing of individuals and communities in the RISE areas of Burkina Faso. 4 Contents About E2A ................................................................................................................................................. 2 Acronyms .................................................................................................................................................. 3 Executive Summary ................................................................................................................................... 6 Introduction .............................................................................................................................................. 7 Background ............................................................................................................................................... 8 Project Goal and Objectives ...................................................................................................................... 9 Initial Phase Goal and Objectives .......................................................................................................... 9 Extension Phase Goal and Objectives ................................................................................................... 9 Geographic Scope ................................................................................................................................... 10 Initial Phase Geographic Scope ........................................................................................................... 10 Extension Phase Geographic Scope .................................................................................................... 10 Project Strategy and Activities ................................................................................................................ 11 Baseline Health Facility Assessments.................................................................................................. 11 FP Sensitization and Demand Generation .......................................................................................... 11 Facility-Based Provider Capacity Building and Support to Health Facilities ....................................... 12 Provision of Quality FP Services at the Facility Level .......................................................................... 15 Engagement with Government and Collaboration with Other Partners/Stakeholders ..................... 15 Results ..................................................................................................................................................... 16 Sensitization and referrals at the community level ............................................................................ 16 Provider Capacity Building and Mentorship ....................................................................................... 18 Support to Health Facilities ................................................................................................................. 19 Facility-Based Provision of FP Services ............................................................................................... 19 Lessons Learned ...................................................................................................................................... 20 Challenges ............................................................................................................................................... 20 What Worked to Mitigate these Issues .............................................................................................. 21 Outlook and way forward ....................................................................................................................... 21 ANNEXES ................................................................................................................................................. 22 Annex 1 : List of health facilities in the project’s first phase .............................................................. 22 Annex 2: List of health facilities in the project’s second phase ......................................................... 23 5 Executive Summary The Evidence to Action Project (E2A) is USAID’s global flagship project for strengthening family planning and reproductive health service delivery. The E2A project received field support funding from USAID Burkina Faso mission to implement a new project aimed at accelerating the use and access to quality FP services in Burkina Faso’s Resilience in the Sahel- Enhanced (RISE) zones from March 2018-June 2020. RISE is USAID’s project that combines humanitarian and development assistance to address the root causes of persistent vulnerability. USAID aims to reduce chronic vulnerability by strengthening economic wellbeing, institutions, and governance and by improving the health and nutritional status of populations. Family planning (FP) is critical to address the root causes of vulnerability in these communities. The E2A-implemented RISE-FP project focused on improving the quality of FP services, and creating demand through community platforms set up under RISE I, in the East and Center North regions of Burkina Faso. The project included a package of interventions, including: FP sensitization and demand generation at the community level, facility-based provider capacity building and support to health facilities, provision of quality voluntary FP services at the facility level, and engagement with government and collaboration with other partners and stakeholders. Over the course of the two years of implementation, a total of 151 FP focus group sessions were held over the course of the project. The total number of participants is 18,741 including 1,548 youth (8,25%) and 15,447 women (82.42%). A total of 5,939 referrals for FP services were made, and 5,222 (87,9%) of those referrals were confirmed at the health facility using the project’s referral system. Of these confirmed referrals, 45.7% chose a long-acting method. In total, the project achieved 28,601 couple years of protection (CYP). The project was also able to build the capacity of facility-based providers. During the beginning of the project, 162 providers were trained in clinical FP provision. These trained providers received clinical mentorship