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Towards reduction of maternal and perinatal mortality in rural Burkina Faso: communities are not empty vessels
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. University of Aberdeen, Immpact, Aberdeen, Scotland.ORCID iD: 0000-0001-5474-4361
2009 (English)In: Global health action, ISSN 1654-9880, Vol. 2Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Reducing maternal and perinatal mortality in sub Saharan Africa remains challenging and requires effective and context specific interventions. OBJECTIVE: The aims of this paper were to demonstrate the impact of the community mobilisation of the Skilled Care Initiative (SCI) in reducing maternal and perinatal mortality and to describe the concept and implementation in order to guide replication and scaling up. DESIGNS: A quasi experimental design was used to assess the extent to which the SCI was associated with increased institutional births, maternal and perinatal mortality reduction in an intervention (Ouargaye) versus a comparison (Diapaga) district. A geo-referenced census was conducted to retrospectively assess changes in outcomes and process measures. A detailed description of activities, rationale and timing of implementation were gathered from the SCI project officers and summarised. Data analyses included descriptive statistics and multivariate analyses. RESULTS: At macro level, the main significant difference between Ouargaye and Diapaga districts was the scope and intensity of the community-based interventions implemented in Ouargaye. There was a temporal association relationship before and after the implementation of the demand-driven interventions and a remarkable 30% increase in institutional births in the intervention district compared to 10% increase in comparison district. There was a significant reduction of perinatal mortality rates (OR =0.75, CI 0.70-0.80) in intervention district and a larger decrease in maternal mortality ratios in intervention district, although statistical significance was not reached. A comprehensive framework of community mobilisation strategy is proposed to improve maternal and child health in poorest communities. CONCLUSION: Controlling for the availability and quality of health services, working in partnership and effectively with communities, and not for them - hence characterising communities as not being empty vessels - can have impacts on outcomes. Here, in the district with a community mobilisation programme, there was a marked increase in institutional births and reductions in maternal and perinatal deaths.

Place, publisher, year, edition, pages
CoAction Publishing, 2009. Vol. 2
Keyword [en]
community mobilisation, effectiveness, maternal and perinatal mortality, Burkina Faso
National Category
Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:umu:diva-30543DOI: 10.3402/gha.v2i0.1947ISI: 000208160000010PubMedID: 20027267OAI: diva2:284631

This work was undertaken as part of Immpact, funded by the Bill & Melinda Gates Foundation, the UK Department for International Development, the European Commission and USAID. Immpact is an international research programme (website: which also provides technical assistance through its affiliate organisation, Ipact.

Available from: 2010-01-08 Created: 2010-01-08 Last updated: 2015-04-29Bibliographically approved

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