Background
Method
Context
Description of the intervention
-
for mothers: prevention, management and treatment of PPH at day 6–10; detection and management of postpartum sepsis at day 6–10; detection, management and treatment of postpartum anaemia at day 6–10, week 6–8, and month 9; and advice on (and provision of) postpartum FP at week 6–8 and month 9.
-
for infants: detection management and treatment of infant danger signs at day 6–10, week 6–8, and month 9.
-
Preparatory activities and meetings with HF managers and female community health workers (CHWs), and personnel in charge of immunization and maternal health; workshops with health workers in each facility (July 2013).
-
Training and retraining of facility health workers (FHWs) on PPC interventions within the MOMI project including integration (September 2013, December 2013 and March 2015); FHWs started the implementation of the intervention in September 2013.
-
Development and distribution of PPC checklists for FHWs, and training in their use (20 January to 5 February 2014); the checklists detailed the contents of the visit for mother and infant.
-
Quarterly supervision from October 2013 to December 2015 covering the provision of activities according to checklists, monitoring of the outputs, discussion and solving problems of HWs in order to maximize their performance [15].
Study design
Data collection
Data analysis
Primary health facility | Infants immunization N | Linked data | ||
---|---|---|---|---|
n | % | |||
Rural HF | Basnere | 396 | 237 | 60% |
Damesma | 263 | 150 | 57% | |
Delga | 401 | 289 | 72% | |
Kalambaogo | 532 | 271 | 55% | |
Lebda | 494 | 271 | 55% | |
Namsigui | 506 | 187 | 37% | |
Napalgue | 322 | 192 | 60% | |
Tangasgo | 186 | 117 | 63% | |
Total rural HF
|
3100
|
1714
|
55%
| |
Urban HF | Sector 1 | 1822 | 454 | 25% |
Sector 4 | 625 | 181 | 29% | |
Sector 6 | 1357 | 353 | 26% | |
Sector 7 | 541 | 72 | 13% | |
Total urban HF
|
4345
|
1060
|
24%
| |
Total
|
7445
|
2774
|
37%
|
Results
Description of the sample/data
Monitored indicators
Primary health facilities | Number of live birth deliveries | Day 6–10 PPC | Week 6–8 PPC | PPFP choice | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N | n | % | Monthly observations | n | % | Monthly observations | n | % | Monthly observations | |||||
n | % | n | % | n | % | |||||||||
Rural HF | Basnere | 1295 | 1110 | 86% | 36 | 90% | 732 | 57% | 36 | 90% | 186 | 14% | 40 | 100% |
Damesma | 701 | 466 | 66% | 36 | 90% | 189 | 27% | 36 | 90% | 174 | 25% | 24 | 60% | |
Delga | 950 | 672 | 71% | 34 | 85% | 539 | 57% | 35 | 88% | 133 | 14% | 26 | 65% | |
Kalambaogo | 1278 | 1046 | 82% | 37 | 93% | 924 | 72% | 37 | 93% | 196 | 15% | 40 | 100% | |
Lebda | 953 | 842 | 88% | 37 | 93% | 642 | 67% | 37 | 93% | 139 | 15% | 22 | 55% | |
Namsigui | 1289 | 657 | 51% | 28 | 70% | 481 | 37% | 28 | 70% | 137 | 11% | 24 | 60% | |
Napalgue | 962 | 620 | 64% | 34 | 85% | 462 | 48% | 32 | 80% | 128 | 13% | 21 | 53% | |
Tangasco | 501 | 380 | 76% | 35 | 88% | 260 | 52% | 33 | 83% | 119 | 24% | 21 | 53% | |
TotaL rural
|
7929
|
5793
|
73%
|
37
|
93%
|
4229
|
53%
|
37
|
93%
|
1212
|
15%
|
40
|
100%
| |
Urban HF | Sector 1 | 2512 | 784 | 31% | 28 | 70% | 240 | 10% | 27 | 68% | 393 | 16% | 26 | 65% |
Sector 4 | 1421 | 1089 | 77% | 40 | 100% | 424 | 30% | 40 | 100% | 220 | 15% | 27 | 68% | |
Sector 6 | 1837 | 830 | 45% | 36 | 90% | 320 | 17% | 32 | 80% | 262 | 14% | 26 | 65% | |
Sector 7 | 1573 | 785 | 50% | 30 | 75% | 208 | 13% | 30 | 75% | 345 | 22% | 29 | 73% | |
Total urban
|
7343
|
3488
|
48%
|
40
|
100%
|
1192
|
16%
|
40
|
100%
|
1220
|
17%
|
28
|
70%
| |
TOTAL HF
|
15,272
|
9281
|
61%
|
40
|
100%
|
5421
|
35%
|
40
|
100%
|
2432
|
16%
|
40
|
100%
|
Effects of the package of interventions on the utilization of PP services
Results per primary health facilities
Primary health facilities | % of pair mother newborn/infant who received postpartum care at day 6–10 | % of pair mother newborn/infant who received postpartum care at week 6–8 | % of women who used a PPFP method | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Sept12-Aug13 | Sept13-Aug14 | Sept14-Aug15 | Sept15-Dec15 | Sept12-Aug13 | Sept13-Aug14 | Sept14-Aug15 | Sept15-Dec15 | Sept12-Aug13 | Sept13-Aug14 | Sept14-Aug15 | Sept15-Dec15 | ||
Rural HF | Basnere | 43% | 99% | 98% | 100% | 16% | 61% | 78% | 73% | 2% | 3% | 29% | 29% |
Damesma | 16% | 83% | 93% | 77% | 5% | 35% | 46% | 8% | 0% | 36% | 42% | 5% | |
Delga | 10% | 92% | 94% | 57% | 11% | 63% | 85% | 43% | 0% | 13% | 26% | 8% | |
Kalambaogo | 50% | 92% | 90% | 103% | 53% | 74% | 81% | 87% | 19% | 11% | 19% | 7% | |
Lebda | 72% | 74% | 116% | 98% | 59% | 44% | 94% | 90% | 0% | 5% | 30% | 37% | |
Namsigui | 0% | 51% | 82% | 84% | 0% | 17% | 72% | 78% | 0% | 7% | 9% | 49% | |
Napalgue | 17% | 70% | 91% | 93% | 12% | 32% | 86% | 80% | 0% | 9% | 27% | 24% | |
Tangasco | 25% | 96% | 110% | 91% | 5% | 54% | 82% | 109% | 0% | 8% | 40% | 92% | |
Total rural HF
|
30%
|
81%
|
95%
|
92%
|
21%
|
48%
|
79%
|
75%
|
3%
|
11%
|
25%
|
30%
| |
Urban HF | Sector 1 | 0% | 39% | 46% | 49% | 0% | 11% | 13% | 21% | 0% | 7% | 35% | 23% |
Sector 4 | 79% | 75% | 80% | 68% | 35% | 31% | 26% | 25% | 0% | 10% | 34% | 13% | |
Sector 6 | 15% | 43% | 62% | 63% | 1% | 11% | 28% | 38% | 0% | 11% | 30% | 6% | |
Sector 7 | 6% | 62% | 67% | 70% | 1% | 16% | 17% | 24% | 0% | 10% | 41% | 43% | |
Total urban HF
|
20%
|
51%
|
61%
|
61%
|
7%
|
16%
|
20%
|
27%
|
0%
|
9%
|
35%
|
22%
| |
Total HF
|
25%
|
67%
|
78%
|
76%
|
14%
|
33%
|
50%
|
51%
|
2%
|
10%
|
30%
|
26%
|
Results per place of residence: ITSA
Day 6-10 PPC | Week 6-8 PPC | PPFP choice | ||||
---|---|---|---|---|---|---|
Rural | Urban | Rural | Urban | Rural | ||
(1) | (2) | (3) | (4) | (5) | ||
Variables
| ||||||
T | Time since the start of study (September 2012-December 2015) | 3.952*** | 3.388*** | 4.086*** | 1.302*** | -0.113 |
(0.818) | (0.181) | (0.411) | (0.0824) | (0.0886) | ||
X | Effect immediately after the intervention initiation | 17.21*** | 7.341** | -8.195 | -3.678* | 1.760 |
(4.211) | (2.419) | (5.200) | (1.657) | (1.080) | ||
X*T | Interaction of the intervention and the time | -3.114** | -2.810*** | -2.261*** | -0.735*** | 1.247*** |
(0.958) | (0.194) | (0.492) | (0.123) | (0.148) | ||
Constant | 20.64*** | -2.186 | 8.116** | -1.394* | 4.031*** | |
(5.127) | (1.550) | (2.566) | (0.528) | (0.731) | ||
Treated: _b[T]+_b[X*T] |
Intervention trend
| 0.8381 ** | 0.5787*** | 1.8250*** | 0.5676*** | 1.1335*** |
(0.2738) | (0.1100) | (0.3267) | (0.1038) | (0.1099) | ||
Number of monthly observations
| 37 | 40 | 37 | 40 | 40 |
Integration of mother PP services into infant immunization services
Primary health facility | Linked data | Day 6–10 PP visit (Yes) | Integrated BCG and day 6–10 PP visit (Yes) | |||||
---|---|---|---|---|---|---|---|---|
N | n | % |
p
| n | % |
p
| ||
Rural HF | Basnere | 237 | 209 | 88% | *** | 27 | 11% | *** |
Damesma | 150 | 143 | 95% | 19 | 13% | |||
Delga | 289 | 243 | 84% | 15 | 5% | |||
Kalambaogo | 271 | 217 | 80% | 2 | 1% | |||
Lebda | 271 | 258 | 95% | 21 | 8% | |||
Namsigui | 187 | 160 | 86% | 27 | 14% | |||
Napalgue | 192 | 175 | 91% | 42 | 22% | |||
Tangasgo | 117 | 100 | 85% | 4 | 3% | |||
Total rural HF
|
1714
|
1505
|
88%
|
157
|
9%
| |||
Urban HF | Sector 1 | 454 | 404 | 89% | 72 | 16% | ||
Sector 4 | 181 | 151 | 83% | 0 | 0% | |||
Sector 6 | 353 | 291 | 82% | 41 | 12% | |||
Sector 7 | 72 | 64 | 89% | 2 | 3% | |||
Total urban HF
|
1060
|
910
|
86%
|
115
|
11%
| |||
Total
|
2774
|
2415
|
87%
|
272
|
10%
|