Community Health Workers’ Involvement in Mother-Child Care During the First Year After Birth, in Kaya Health District, Burkina Faso: A Contribution Analysis

Abstract Background: Maternal and infant morbidity and mortality remain high in the world and particularly in sub-Saharan Africa. However, actions to strengthen postpartum care are still weak and mainly limited to health facilities (HFs). The Missed Opportunities in Mother and Infant Health (MOMI) project implemented in the Kaya health district in Burkina Faso included community-based health workers (CHWs) in the care of women and children during the first year postpartum through home visits, accompanying mothers to health facilities and outreach sessions. The aim of this study was to assess the contribution of CHWs to postpartum women’s health facilities attendance.Methods: We conducted an effect assessment using Mayne and Lemire's contribution analysis framework. This was a mixed methodsstudy. Qualitative and quantitative data were collected through project document review and individual semi-structured interviews with key-informants.Results:The CHW carried out home visits, accompanied women to HFs, conducted outreach sessions and referred to health facilities, mothers or children who were showing signs of danger.All the participants interviewed acknowledged that the number of women, who came to postpartum care, had increased since the implementation of the project activities. Postpartum consultation rates within the first week postpartum increased from 29% in 2011 to 80% in 2015 and from 19% to 50% within 6 weeks. Others interventions such as the Performance based financing, the Save The Children (NGO) nutritional project and the health services component of MOMI were the alternative explanations.Conclusions: Community-based health workers involvement in the care of women contributed to improve their adherence to postpartum consultations in Kaya health district.