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Burkina Faso

Burkina Faso faces widespread poverty and a rapidly growing population. The 2010 Human Development Report ranked Burkina Faso 161st out of 169 countries on a composite indicator of human development that includes life expectancy, education, and standard of living. According to the World Bank in 2008, Burkina Faso has the fifth highest population growth rate in the world (3.4%). One reason for Burkina Faso's soaring population growth is low use of family planning (FP): Preliminary data from the 2010 Demographic and Health Survey (DHS) show that the contraceptive prevalence rate (CPR) among married women is only 16.2%. Use of modern methods is slowly rising: The modern-method CPR increased from 8.6% in 2003 to 15.0% in 2010. A very small percentage (4%) of married women use LA/PMs. From 2003 to 2010, Burkina Faso's total fertility rate (TFR) declined slightly, from 6.2 to 6.0 lifetime births per woman. It remains one of the highest TFRs in the world. Unmet need for contraception is high in Burkina Faso. The 2003 DHS found that 22% of married women have an unmet need for birth spacing, and an additional 7% have an unmet need for birth limiting. Moreover, 58% of married women who were not using a method at the time of the 2003 survey expressed a desire to use a method in the future.

RESPOND's strategy in Burkina Faso is to provide the Directorate for the Health of Mothers and Children (DSME) and nongovernmental organizations with technical assistance addressing the three pillars of effective FP programs: supply, enabling environment, and demand. The project addresses supply and demand in three health districts and the enabling environment for FP at the national level. 

On the supply side, RESPOND is assisting the DSME to update FP providers in FP counseling, infection prevention, and clinical FP, including long-acting methods. Since health center cleaning staff share a large part of the responsibility for preventing infection, RESPOND and the DSME are also training cleaning staff on infection prevention. RESPOND will also be training district-level doctor-nurse teams in permanent methods. In addition, RESPOND will build the capacity of DSME supervisors through training in facilitative supervision and the COPE process for quality improvement. Furthermore, RESPOND is providing technical assistance to the DSME as it organizes special FP days on which FP services are provided free or at a reduced price. Some of these special days are considered "mobile services" because providers with training in LA/PMs travel to lower-level facilities to expand the range of contraceptive options available on the special day. 

On the demand side, JHU•CCP leads RESPOND's efforts to increase and improve communication about FP, including LA/PMs. Having completed formative research in the previous project year, RESPOND will hold a workshop to develop information, education, and communication (IEC)/behavior change communication (BCC) messages. Based on the results of the workshop, RESPOND will develop, pretest, and produce a number of IEC/BCC materials for different audiences. Some of these materials, such as flipcharts to improve counseling, will be designed for use at health centers. RESPOND will also reach a wider audience through spots on community radio that communicate the benefits of FP. In addition, RESPOND will recruit volunteers who are providers, satisfied clients, and community members to serve as FP champions. Champions will discuss FP and answer audience questions on local radio programs.

To improve the enabling environment, RESPOND will advocate for repositioning FP, including LA/PMs, during national-level meetings on reproductive health. RESPOND will build local capacity to set and plan to meet realistic FP targets by training key personnel of the DSME and partner organizations in Reality √. Marie Stopes International recently registered Sino-implant (II) in Burkina Faso under the name "Femplant." However, Sino-implant (II) is not yet available at public health facilities. RESPOND will discuss this issue with the DSME and make recommendations on how to increase access to a range of methods at public facilities. Additionally, RESPOND will advocate for the Ministry of Health to authorize auxiliary birth attendants to provide implants and the intrauterine device. 

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Photo credits: M. Tuschman/EngenderHealth; A. Fiorente/EngenderHealth; C. Svingen/EngenderHealth.

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