Quality of care and effective coverage of child health services in rural Burkina Faso

Abstract

Objective To evaluate the technical quality of child health services at the first level facilities in Burkina Faso and determine the effective coverage of child health services. Methods A cross sectional study was conducted in six regions of Burkina Faso and the data was collected from facility and household surveys. To assess the quality of care we used signal functions of three dimensions of care (routine care, management of severe childhood diseases and non-medical aspects of care) the availability of relevant drugs, equipment and the staffing. Each of this dimension was categorized in high, intermediate and low quality level. Linking the household survey to health facility assessment we determined the proportion of children who sought care in facilities with high quality level. We calculate the effective coverage of preventive childcare defined as the proportion of children who have completed the specific vaccination schedule appropriate to their age. Results In total, 494 primary healthcare facilities and 8205 households were included in the study. More than half of health facilities (51%) had high quality level regarding non-medical care aspects while more than 70% of primary care health facilities had a low quality level in management of severe childhood diseases. We found globally that 50% of health facilities had a low quality in all dimensions. While 69.7% of sick children sought care in a health facility, only 18.8% of them went in facilities high quality. There was a large difference between effective coverage and crude coverage of vaccination in the study regions. Conclusion Our assessment found that the quality level in the health facilities was low, and the quality gap was large. In addition, there was a low effective coverage of vaccination in the study regions. Effective coverage could be a relevant metric to improve the performance of child health services.