Analysis of the quality of seasonal malaria chemoprevention provided by community health Workers in Boulsa health district, Burkina Faso

Abstract

Background Since 2014, the Burkina Faso government has made Seasonal Malaria Chemoprevention (SMC) a priority in its strategic plan to fight against malaria among children aged from 3 to 59 months. Very few studies have examined the care provided by community health workers in the framework of this strategy. The purpose of this study was to evaluate the level of quality of care provided by the latter. Methods This was a mixed study. The quantitative component consisted of a non-participant observation of community health workers during the administration of care. The qualitative component consisted of one-on-one interviews with community health workers, child caregivers and head nurses. Five dimensions (organizational accessibility, interpersonal relationship, technical competence, safety of care and satisfaction of child caregivers) adapted from the Donabedian quality of care model were used to assess the quality level of care. The Corlien et al. Health Systems Research Program Implementation Scale was used to establish quality scores for each of the five dimensions. The study sites were the health centers located in the administrative centers of the 4 communes of the health district of Boulsa. The data were collected during the first cycle of the 2017 SMC campaign. Results A total of 14 active pairs (28 CHWs) were observed and 40 in-depth interviews with community health workers, Head nurses in duty and community leaders were conducted. The results show that community health workers worked in pairs. They had all received SMC training and possessed equipment to do their job. The dimensions of organizational accessibility and satisfaction of the caregivers were rated as good. The dimensions of interpersonal relationship and technical competence were judged to be of an acceptable score. Safety of care was judged to be of a low-level score. The overall quality of care was considered acceptable. Conclusion The results of this study have shown that despite the difficulties faced by community health workers, they manage to deliver acceptable quality of care. Their use would be an asset for SMC in particular and for the health system in general. Electronic supplementary material The online version of this article (10.1186/s12913-019-4299-3) contains supplementary material, which is available to authorized users.

Longitudinal analysis of the capacities of community health workers mobilized for seasonal malaria chemoprevention in Burkina Faso

“…These results are nonetheless consistent with another study on community health workers' performance conducted in Burkina Faso, Nigeria, and Uganda, where 98% of the tasks were mastered by respondents [15]. They are also consistent with those of a recent observational study conducted in the same context with 14 CBDs, which concluded that they "deliver acceptable quality of care" [16]. Studies have also shown that SMC has contributed significantly to reducing both malaria transmission and the biological prevalence of anaemia in children under five [3].…”

Co-implementing vitamin A supplementation with seasonal malaria chemoprevention in Sokoto State, Nigeria: a feasibility and acceptability study

“…One of the fears of integrating interventions or health service delivery is a compromise on quality of delivery following integration. This has been adduced to low adherence to quality guidelines due to limited time or extra workload [ 31 ]. However it has been established that CHWs can deliver quality services with adequate supervision, motivation and supplies [ 16 ].…”

Using systems thinking to understand scale-up and sustainability of health innovation: a case study of Seasonal malaria chemoprevention processes in Burkina Faso

“…These obstacles include a lack of stable funding, retention challenges, inadequate training and supervision, and parallel and concurrent interventions. Our study and another [44] carried out on SMC in Burkina Faso showed that the overload of work of community distributors contributed to decreasing their performance in the effective administration of drugs and the transmission of information to caregivers. Therefore, by grafting a new intervention such as SMC into a "faulty" system without providing systemic solutions to existing problems, there is a risk of jeopardizing the sustainability of innovations or the quality of other existing interventions.…”