Community-based health agents practices in Burkina Faso

Abstract

Abstract Background It is estimated that around 25% of the world's infant mortality is in West Africa where undernutrition accounts for more than 50% of the underlying causes of under-5 mortality. Malnutrition rates have decreased slightly, especially compared to the targets set for 2025. Since Alma-Ata's declaration in 1978, community participation in primary health care has been one way of reducing health inequalities. WHO recommended the integration of community health workers (CHW) into the health system and their inclusion in the human resources planning strategy. We observed a decline of programs involving CHW in the 1990s, then a definite revaluation since the 1990s and specifically, since 2012. They provide health education, as well as referral for a range of services, and provide support and assistance to communities and families through preventive health, easier access to curative health services as well as social services. The specific objectives of this project include: to describe the roles and functions of CHW in Burkina Faso, to identify the workers' needs, to explore the changes in the system and to identify the conditions related to their deployment. Methods A qualitative case study allowed to describe the processes and also facilitated the discovery of key elements related to the experiences of community agents, considering the elements of complexity and context. Results Our results include activities in promotional services, preventive services, curative services and health data management. In addition, we will shed light on their feelings and experiences related to integration into the system, on the strategies they use, on the advantages that bring their role as community workers, their concerns and finally, we will share their perception of their impact. Some recommendations are proposed in regards to training and supervision. Key messages CHW are major players in health systems by creating a bridge between health and social service providers and communities with reduced access. CHW contributes to social justice by facilitating access, promoting recognition and creating empowering processes through increased participation.