Burkina Faso: Reducing child mortality

In Burkina Faso, an innovative concept launched in mid-January will make it possible to offer better healthcare to more than half a million children under five, thus reducing child mortality.

Just imagine a primary health care centre in Burkina Faso: we are out in the bush, the small one-storey building is pervaded by the red dust brought in from the nearby desert. Wrapped in bright garments, mothers are patiently waiting for their consultations in the shade of a shed, babies on their backs. The place is open to the winds; goats and fowls wander around. No electricity, running water or tarmac has yet reached this village.

The male nurse calls the next patient. White coat, stethoscope, assured air, he gets out his touchpad and starts to question the mother and examine the child. In a few moments he enters the information on his device and instantly receives the right diagnosis and treatment with its dosage. The nurse writes a prescription for the mother and ‘pushes’ the Electronic Medical Record of the child into Cloud Storage. The stock of the pharmacy is immediately up-dated and the health district management team registers the consultation.

That evening, the nurse turns on his tablet again, peruses the day’s results, replies to questions from the district medical officer and starts his half-hour of continuing online education. In 2016, this scenario will become reality . . .

A daring challenge

In this country, one of the world’s poorest, one child in six does not reach the age of five, mainly due to badly-diagnosed minor conditions. Burkina Faso is desperately lacking in qualified medical personnel (http://www.tdh.ch/en/countries/burkina-faso). There is but one doctor for ten thousand inhabitants (compared with Switzerland, where there are 41 doctors for the same number of people), and this is the reason why children are usually examined by a nurse or health agent in rural areas.

Today, however, we should be able to prevent at least 80% of these deaths caused by malnutrition, malaria, diarrhoea, parasitosis and respiratory infections. For this reason, Tdh, in collaboration with the Burkina Faso Ministry of Health and with the support of the Bill & Melinda Gates Foundation, has launched the IeDA . This innovative project will make it possible to improve the country’s healthcare system by computerizing the data from healthcare centres for children under five.

The approach is built on four hundred electronic tablets equipped with a SIM card and software, with the aim of improving the diagnoses made by nurses out in the brush.

Exemption from payment for universal access to treatment

In advance of this technological innovation, a third-party payer system has been tried out by Tdh in the same two health districts since 2008. This allows exemption from payment for healthcare for all children under five, as well as for pregnant and breastfeeding women. Free healthcare has in particular multiplied by seven the number of consultations for children, generating over three contacts per year per child, and 100% of the births are assisted by qualified personnel.

One of the essential factors needed to ensure the success of implementing exemption of payment has been the establishment of an inspection system to avoid abuses. This has made it possible to reduce the cost of consultation and treatment of childish ailments treated in the healthcare centres by 40%.

The results speak for themselves

The situation is gradually improving, thanks to the combined actions of supporting the healthcare systems, the integrated treatment of childish ailments, the free treatment and its good quality. The Head of Tdh’s delegation in Burkina Faso, David Kerespars, is very satisfied with the progress made in the six years of the project. “In the Boucle du Mouhoun region, for example, the rate of acute malnutrition has gone down from 15% to 5%!” He added that screening coverage is now estimated to be 100%.

With 100 Swiss Francs

Terre des hommes can finance a whole year of access to health services for 20 children under five