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Introduction: we conducted a pilot study for transferring skills for intrauterine device (IUD) insertion and implants to primary health care workers (PHCWs) as well as to provide injectable contraceptives to community health workers (CHWs) in 20 Health Centers in the Tougan Health District. This was aimed to increase access to contraceptive methods in Burkina Faso. Moreover, the purpose of this study was to assess the quality of family planning (PF) services offered by these delegated (PHCWs and CHWs)., Methods: we conducted a cross-sectional, descriptive, analytical study. Data collection was based on quantitative and qualitative methods. It included the 20 health centers in the study area and all providers (54) involved in contraceptive product supply (delegators and delegatees). Nineteen (19) recipients including 10 new contraceptive users were interviewed. The method of data collection included the observation of FP services and of the working environment, document review and individual interviews. Data were analyzed using Epi info 7 and Open Epi version 3.01. software. Chi-square test and Student's t-test were used to determine whether there was significant difference between the quality of PF services offered by the delegators and that of the delegatees., Results: PF service quality score in the study area was 73% for the delegators' vs 69% for the delegates. There was no statistically significant difference between these scores. However, there was a statistically significant difference between the quality score of community health workers (75.8%) and the quality score of counselors (delegators; 87.5%) (P <0.05). It was the same for quality score determining who was eligible for implants. The quality score of PHCWs was higher than that of delegators: 79% for delegators, 64% for delegatees., Conclusion: this purpose of this study was to improve the geographic coverage for long-acting contraceptive methods. Under certain conditions (skills-building, monitoring, coaching), it is possible to extend the transferring of skills for long-acting contraceptive methods to PHCWs as well as the provision of injectable contraceptives to CHWs, while maintaining a satisfactory level of FP service quality., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts., (© Souleymane Kaboré et al.)

Introduction: In order to cover the shortage of midwives (MWs) in the health district of Tougan, Burkina Faso, a strategy for the decentralization of emergency obstetric cares, based on ad hoc interventions undertaken by MW to manage obstetric complications in health centers (HCs), has been developed in rural areas. This study aimed to describe this experience and to analyze the achieved results., Methods: We conducted a cross-sectional, analytical, intervention study based on a review of routine data from all the parturients treated from 2013 to 2015. Data collection took place from 5 to 20 January 2016. Chi-square Test, odds ratios (ORs) and their 95% confidence intervals were calculated., Results: A total of 416 parturients with obstetric complications were treated by zonal MW. The average age of patients was 26.4 years. The median distance travelled to treat parturients was 15 km, with an average intervention period of 21.1 minutes (standard deviation = 7.13 minutes). Dystocias accounted for half (50.7%, CI95%= 45.8-55.6) of treated complications followed by hemorrhage (26.4%, CI95%= 22.3%-31.0%). More than 77% of interventions resulted in local resolution of obstetric complications. Finally, the intervention outcome was subject to the pathology treated (OR=5.88; p < 0.001)., Conclusion: This strategy was an answer to the shortage of MWs in the perypheral HCs in the health district of Tougan. In this particular context, this intervention could provide an alternative solution to the shortage of human resources for health in rural areas.

Introduction: Today, thanks to the HAART, HIV has become a chronic disease. In most cases, HIV positive women are of reproductive age and at present, the vertical transmission rate is around 0.1% for women with an undetectable viral load. So, it is normal that the question of seropositive women's desire to have children is on the table., Methods: In this experimental study, 50 HIV-seropositive and 44 seronegative women were interviewed about their desire to have children. Some of the questions asked were: "How many children did you want to have before you got married/at 15 years of age if you aren't married?" "How many children would you like to have today, considering your present situation?". In case of a difference between "before" and "now", we asked them: "What are the reasons for this difference?". This study was performed in Burkina Faso., Results: The positive women tend to desire more children "before" and fewer children "now" than negative women (OR: 1.33; C.I. 95%: 0.86-2; p= 0.19 vs OR: 0.78; C.I. 95%: 0.51-1.21; p= 0.27). 62% of HIV positive women mention multiple reasons directly linked to their seropositivity to explain the difference between "before" and "now". 70% of HIV positive women still want to have children. We have noted that the positive women who still want children are more likely to be younger (p < 0.05 by Two-Sample T tests), in a relationship (p < 0.01 by Chi-Square Test) and to have been diagnosed earlier than the positive women who don't want any children (p=0.01 by Wilcoxon Rank Sum Test)., Conclusion: Even if the results of this pilot study are preliminary, they show that HIV positive and negative women have a relatively similar desire for children, even though seropositive women seem to want fewer children than their uninfected counterparts. Most of the reasons which reduce HIV positive women's desire to have children are directly linked to HIV. This is why getting these women informed about materno-fetal transmission risks and existing treatments is really important to give them the opportunity to make a conscious choice.