La vulnérabilité alimentaire au Burkina-Fasso (French Edition)

The Nutrimad programme aims to contribute to improving the nutritional status of children from birth to age It is divided into two sub-programmes: Adding amylase to fortified blended foods can improve energy density, and increase child's energy and nutrient intake. Traditional fermented millet gruel is frequently eaten by children in Burkina Faso as a complementary food or for breakfast. The effects of gruel energy density and feeding style on intakes amounts and energy were assessed in children in In Vietnam, nutrition interventions do not target school children despite a high prevalence of micronutrient deficiencies.

The present randomised, placebo-controlled study evaluated the impact of providing school children n with daily multiple micronutrient-fortified biscuits FB or a Traditional complementary foods CF with a low nutrient density have been implicated in growth faltering, stunting, and other adverse outcomes in children. The efficacy of 2 types of locally produced, micronutrient-fortified CF to prevent stunting of infants living In numerous developing countries, a large proportion of preschool children suffer from chronic malnutrition that leads to higher mortality, stunting and, later, learning difficulties and a lower capacity to participate in the development of their countries.

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Gret - Professionals for Fair Development. Both encouraging feeding style and high energy density may increase energy intakes from fermented millet gruels eaten by infants and toddlers in Ouagadougou A six-month intervention with two different types of micronutrient-fortified complementary foods had distinct short- and long-term effects on linear and ponderal growth of Vietnamese infants.

Regular Consumption of complementary foods fortified with micronutrients improves iron status of vietnamese infants INACG Research and application of complimentary food fortification in Vietnam J. Phu Hanoi Medical College , A. Implementation and Evaluation of Complementary Food Programs: Efficacy and Effectiveness Studies, impact assessment. The Vietnam experience For the women close to term, the location of childbirth was seldom discussed, and signs of alert were also not properly discussed.

Most risk factors were not considered in an active way, and women at risk did not benefit from any particular care. Other obligatory complementary examinations were required only in the reference maternity centre of the district; serology toxoplasmosis and echography were not requested at all. Anti-tetanus vaccination was suggested in all the cases when the woman was not properly vaccinated or had no vaccination record.

The dose was specified in all the cases but less was said about the importance of these regulations to the women. The difficulties faced in the provision of good-quality ANC mentioned by the health workers were practically the same for all the health centres. These were poor attendance at the health centres, the delay in the use of prenatal care by women generally in the second or third trimester , or even only in the case of an emergency health problem, the weak observance of anti-malaria chimioprophylaxis and anti-anaemics, and the refusal of some women to be examined by a male health worker.

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Some health centres with a weak obstetrical coverage rate still ranked well for the provision of care; in the same way, some health centres had a relatively-good obstetrical coverage rate, despite their low score for the provision of care. There was also a significant variability among the health centres.

This rate of professional childbirth is low, below the average in developing countries. Four in five study women had given birth in the home. This high rate of childbirth in the home gives a glimpse of the high rate of maternal mortality in the district and means that the Objective 5 of MDGs is unlikely to be reached. Unfortunately, we were not able to estimate the maternal mortality rate in this study because of its retrospective design, the weakness of the health information system, and the resulting absence of systematic identification and recording of maternal deaths.

This weak obstetrical coverage is probably, to some extent, related to the same factors found in other studies, such as geographical and financial accessibility and health facilities 22 — 25 , socioeconomic barriers, or the educational level of women Indeed, in most developing countries, charges for health services have to be paid for directly. However, these factors alone could not explain why so many women, who had attended antenatal consultations, did not use assisted childbirth.

Our initial assumptions were on the role of other factors, particularly the provision of care and the quality of ANC. It was shown that the lack of qualified staff, poor management of existing staff, bad allocation of limited resources, bad relationships between health workers and pregnant women, and the lack of tools account for the unsatisfactory provision of maternal care, which is decisive for a good obstetrical coverage The set of the scores for health staff, training of staff, equipment, and skills in reproductive health was weak in our study.

We found no significant correlation between the different scores for the functioning of health services and the obstetric coverage. We could question our methodology for the measuring equipment and the provision of care and particularly the fact that the total score combines different aspects equipment, staff, and training.

However, when tested independently, the three corresponding scores did not show any further links with the obstetrical coverage results not shown. We can, thus, only make assumptions to explain this result, including the fact that the provision of care is simply not a key factor in this underprivileged context where tradition plays a significant role. We could also assume that the overall provision of care is weak in the province and that the situation is too homogeneous for the role of care provision to be revealed, despite the relative differences between the health centres.

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The main reason for the low obstetrical coverage could be the quality of care provided in the antenatal period. This is recognized as a determining factor in the use of health services One study on the factors that influence the health facilities chosen at delivery has shown that the women's choice of facility is based on the quality of previous experience and on her trust in health workers at the facility Like the results of previous studies in other countries 4 and also of other studies in Burkina Faso 14 , 16 , 31 , we recorded failures at all the stages of ANC.

We did not find a significant link between the obstetrical coverage and the quality of care but there was a trend. Our appreciation of the quality of care may have been too limited because we were only able to observe only one session per maternity centre, i. We can, thus, suppose that the non-attendance of ANC by pregnant women is related to the poor quality of services, thus introducing a selection bias.

Despite this possible bias, some elements of our observations could help explain the weak use and even the abandonment of health services by the women. The problem of the quality of reception is probably not to blame as it was the most satisfactory point in all the stages of ANC observed, which is often the case in rural areas 32 , in contrast to what is generally observed in urban areas 31 , On the other hand, the failures of other stages of ANC, particularly decision-making and gynaecological examination, are probably involved.

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The lack of screening and the lack of information on the risks of pregnancy, childbirth, and possible treatment that can be provided to patients, and the poor exchanges on planning of childbirth may account for the lack of use of medical facilities for childbirth Moreover, in Burkina Faso, during the demographic and health survey in , women declared that the individual attention that they receive encourages them to continue with their antenatal follow-up, although they also suffered from the lack of information on the signs of risk during pregnancy and the absence of planning of childbirth The main aim of this work was to assess the factors relating to the functioning of health centres to be able to explain the low use of health services at delivery by the women in contrast to the high use of antenatal care services.

Our main conclusion is that the ability of the primary health centres in a rural district in Burkina Faso to provide good antenatal care is low. The key factors involved in the limited use of professional childbirth relating to maternal health services are the quality of antenatal care. Investing in the improved quality of maternal care in the primary health facilities may increase the number of professional deliveries and improve the effectiveness of health facilities in providing facilities for professional delivery.

National Center for Biotechnology Information , U. J Health Popul Nutr. Nikiema , 1 Y. Kameli , 2 G. Capon , 3 B. Sondo , 1 and Y. Author information Copyright and License information Disclaimer. Correspondence and reprint requests should be addressed to: This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. Analysis of functioning of the health centres was undertaken to assess their ability to provide reproductive health services according to the standards established in Burkina Faso, based on the following criteria: Availability of specific and non-specific equipment, drugs and reagents, and data-collection tools at the facility;.

Training experience of the working staff on prevention of infection, family planning, use of partogramme, obstetrical and neonatal emergency care, and breastfeeding. Statistical analysis Data collected were entered using the EpiData softwere 3.

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Open in a separate window. Assessment of ANC procedure Of the 22 health centres visited, in five cases, no woman was receiving an antenatal consultation on the day of our visit and, for logistical and temporal reasons, we were unable to return for a second visit.

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Interviews with health workers The difficulties faced in the provision of good-quality ANC mentioned by the health workers were practically the same for all the health centres. Maternal mortality in World Health Organization; Proposition of birth attended by a skilled health worker: How effective is antenatal care in preventing maternal mortality and serious morbidity? An overview of the evidence. Suppl 1 [ PubMed ]. Potential role of prenatal care in reducing maternal and perinatal mortality in sub-Saharan Africa. J Gynecol Obstet Biol Reprod.

Paris [ PubMed ]. The quality of risk factor screening during antenatal consultations in Niger. Determinants of risk factors associated with severe maternal morbidity: Resolution adopted by the General Assembly. Measuring progress in safe motherhood programmes: Skilled attendants for pregnancy, childbirth and postnatal care. Estimates of maternal mortality worldwide between and Frequency and timing of antenatal care in Kenya: Say L, Rosalind R. A systematic review of inequalities in the use of maternal health care in developing countries: Bull World Health Organ.

Effectiveness of MCH services in detecting of and caring for mothers and children at risk. A comprehensive tool for validated entry and documentation of data. EpiData Association,; EpiData version 3 pp. Epi Info, version 6: Centers for Disease Control and Prevention; Getting started with the SAS System: Barriers to the use of antenatal and obstetric care services in rural Kano, Nigeria. Utilisation of antenatal and maternity services by mothers seeking child welfare services in Mbeere district, Eastern province, Kenya. East Afr Med J. Determinants of use of maternal-child health services in rural Ghana.

Quality of Antenatal Care and Obstetrical Coverage in Rural Burkina Faso

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