Burkina Faso, a predominately rural country in West Africa, has struggled for decades with its high-population density. The average annual income of the impoverished nation is around $300, and Burkina Faso’s citizens are largely undereducated, with a literacy rate of less than 30%. Poverty in Burkina Faso is aggravated by a population growth rate of 3% (for comparison, the population growth rate of the European Union is 0.212%), far beyond what the country’s limited natural resources can adequately support. The government of Burkina Faso has set Millennium Development Goals geared at reducing poverty, and an important cornerstone of the plan is providing Burkina Faso families with access to family planning services. In 2008, the Government launched an innovative community-based distribution (CBD) approach to contraceptives and health information, and its reaping rewards.
The CBD is a collaborative project between the Burkina Faso Government and communities, with technical and financial support from United Nations Population Fund (UNFPA). The objective of the CBD is to reduce unmet family planning needs by making available contraceptives and information to populations living more than 10km (6 miles) away from a health center. The project relies on a large network of local partners called Volunteer Community Health (VCH) workers. The VCH workers are residents of the regions they serve, and though they have no medical training and most are illiterate, they are changing the landscape of family planning in Burkina Faso. VCH workers travel from village to village encouraging couples to seek family planning counseling, dispensing condoms and non-prescription contraceptives such as the pill, and encouraging men to become more involved in reproductive choices that impact their families.
Although some of Burkina Faso’s governing bodies were skeptical of the CBD project, they bravely undertook it and have seen success in reproductive health indicators. The Moaga health center, which serves six villages and a population of over 7,000 people, saw a contraceptive prevalence rate (CPR) increase from 11% in 2009 to 30% in 2011. In the far larger Health District, which serves about 202,000 people, the CPR rose from 32.6% in 2010 to 36.4% in 2011. What that means is that greater numbers of Burkina Faso citizens aged 15-49 are using some form of contraceptive.
Perhaps even more indicative of the programme’s success is the improvement in maternal care and the progressive participation of men in reproductive health. Prior to the CBD programme, pregnant women in Burkina Faso would wait until two months before their delivery to seek medical attention, and after having their babies would not return to health centers despite the urgings of medical professionals. Today, women in Burkina Faso are keeping their antenatal appointments as well as returning to health centers for postnatal care and consultations with their newborn babies. The Moaga health center alone is seeing 400 to 500 children each month. The participation of fathers is a key element in ensuring that Burkina Faso women receive important maternity care. Over the first two months of the program, 53 men accompanied their spouses for consultations—and instead of waiting outside, as has been tradition, they sat with their wives and participated in the conversation about the health and well-being of mothers and their families. Some men are playing an active role in helping their wives choose and maintain a contraceptive plan in order to space the births of their children and provide a greater chance for the family’s economic improvement.
Burkina Faso is one of the main beneficiaries of the UNFPA’s Global Reproductive Health Product Security Program, and receives an average of $5 million per year to facilitate access to universal family planning services. The success of community-based distribution in Burkina Faso demonstrates that the health of the population and family planning services are not the government’s purview alone, but require the involvement of communities.
With the initial successes of CBD now evident, the next phase of the programme is to mobilize financial resources to extend it to all villages and areas of the country, provide greater financial incentives to current and potential partners, and improve the overall management of contraceptives and availability in the villages. Through innovative approaches such as the CBD, Burkina Faso moves ever-closer to achieving its Millennium Development Goals.
- Ronia Holmes
Photo Source: UNFPA