BURKINA FASO – Task sharing for family planning services

by Tieba Millogo, Séni Kouanda, Nguyen Toan Tran, Boezemwendé Kaboré, Namoudou Keita, Leopold Ouedraogo, Fatim Tall, James Kiarie, Nandita Thatte, Mario Festin, Asa Cuzin-Kihl

Bulletin of World Health Organization 2019;97:783-88  DOI: 10.2471/BLT.19.230276 (Open access)

Abstract

Problem – In Burkina Faso, the coverage of services for family planning is low due to shortage of qualified health staff and limited access to services.

Approach – Following the launch of the Ouagadougou Partnership, an alliance to catalyse the expansion of family planning services, the health ministry created a consortium of family planning stakeholders in 2011. The consortium adopted a collaborative framework to implement a pilot project for task sharing in family planning at community and primary health-care centre levels in two rural districts. Stakeholders were responsible for their areas of expertise. These areas included advocacy; monitoring and evaluation; and capacity development of community health workers (CHWs) to offer oral and injectable contraceptives to new users and of auxiliary nurses and auxiliary midwives to provide implants and intrauterine devices. The health ministry implemented supportive supervision cascades involving relevant planning and service levels.

Local setting – In Burkina Faso, only 15% (2,563/17,087) of married women used modern contraceptives in 2010. 

Relevant changes – Adoption of new policies and clinical care standards expanded task-sharing roles in family planning. The consortium trained a total of 79 CHWs and 124 auxiliary nurses and midwives. Between January 2017 and December 2018, CHWs provided injectables to 3,698 new users, and auxiliary nurses or midwives provided 726 intrauterine devices and 2,574 implants to new users. No safety issues were reported.

Summary of main lessons learnt

• Task sharing in family planning was feasible and safe at both community and primary healthcare centre levels.

• Mobilizing key stakeholders catalysed changes in health policies and clinical care standards related to task-sharing in family planning.

• Participatory supervision cascades under the leadership of the health ministry was critical in ensuring the success of the project.

However, financial constraints are hindering scale-up efforts.

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Editor’s note: The process and experiences described in this paper are highly relevant for everyone seeking to implement WHO’s task-sharing guidance for provision of abortion: Health worker roles in providing safe abortion care and post-abortion contraception, July 2015