Pour la première fois, les communes de la région Sahel au Burkina Faso, adoptent et ajoutent la planification familiale à leurs budgets

Par Nongma Sawadogo

Nongma Sawadogo dirige le travail sur la santé des femmes et des enfants pour le programme FCI de Management Sciences for Health (MSH) au Burkina Faso. Cet article est apparu sur le blog K4Health.

Un kiosque de planification familiale au salon de la santé au Burkina Faso. © 2011 Centre pour les programmes de communication, avec la permission de Photoshare

Quand j’étais en formation pour devenir sage-femme, une hôtesse de l’air,  sans argent et dans un  état critique, se présentait  à la maternité de l’hôpital  Yalgado Ouédraogo de Ouagadougou, après avoir eu recours à un avortement raté.  Mes collègues et moi avons cotisé de l’argent afin de lui procurer  ses médicaments essentiels, mais malheureusement elle a succombé à ses saignements (hémorragie)- malgré le fait que nous lui avons administré ses médicaments.

Nous étions choqués. Et je pensais que  nous devons absolument faire quelque chose pour améliorer la santé reproductive des femmes. Quand je pense que cette femme aurait pu être sauvée si seulement elle avait eu accès à la planification familiale. Cela m’a rappelé la raison pour laquelle  je voulais devenir sage-femme (maïeuticien)  – pour sauver des êtres humains.

Cependant,  la planification familiale ne commence pas avec les sages-femmes ou les médecins. En effet, elle commence avec les décideurs politiques et un budget adéquat alloué à cette fin. La planification familiale débute par une forte  volonté politique et de l’argent. Les dirigeants peuvent s’inspirer pour améliorer  l’accès aux services de contraception et de santé reproductive, mais ils doivent aussi  impérativement prouver cet engagement en les incluant parmi les éléments principaux de leurs budgets locaux et  explicitement sur le plan auquel le gouvernement  local envisage l’usage des fonds publics. Continue reading “Pour la première fois, les communes de la région Sahel au Burkina Faso, adoptent et ajoutent la planification familiale à leurs budgets”

For the first time, communes in Burkina Faso’s Sahel region add family planning to their budgets

By Nongma Sawadogo

Version française

Nongma Sawadogo leads work on women’s and children’s health for the FCI Program of Management Sciences for Health (MSH) in Burkina Faso. This article originally appeared on the K4Health Blog.  

A family planning booth at a health fair in Burkina Faso. Photo: Center for Communication Programs, Courtesy of Photoshare

When I was in training to become a midwife, a flight attendant, with no money and in critical condition, arrived at the maternity ward of Yalgado Ouédraogo hospital in Ouagadougou after getting a botched abortion. My colleagues and I put money together to buy her essential medicines, but she eventually died–even after we administered the medicines. We were shocked. And I thought, we must do something to improve women’s reproductive health. When I think that this woman could have been saved if she’d had access to family planning earlier, I’m reminded of my reason for becoming a midwife–to save human beings.

But family planning doesn’t start with midwives or doctors. It starts with political will and with money. If political leaders want to  improve women’s access to contraception and reproductive health services in their communities, they can act on this commitment by making a line item for these services in their local budgets, the local government’s plan for how it will spend public money. Continue reading “For the first time, communes in Burkina Faso’s Sahel region add family planning to their budgets”

EML Search: New resource for reproductive and maternal health advocates

Shafia Rashid is Senior Technical Advisor at the FCI Program of Management Sciences for Health.

In June 2013, Imtiaz Kamal–a crusader for midwifery and women’s health–celebrated Pakistan’s official recognition of the essential maternal health medicine, misoprostol, which has proven easy to administer, safe and effective for preventing and treating excessive postpartum bleeding. “Given the high prevalence of home births,” Imtiaz explained, “we need to invest in solutions, such as misoprostol, that save lives now, until we can achieve the long-term goals of strengthening health systems and increasing rates of facility births.” Continue reading “EML Search: New resource for reproductive and maternal health advocates”

Nongma Sawadogo, midwife and reproductive health champion in Burkina Faso

(Version française ci-dessous)

 

Photo by Catherine Lalonde
Photo by Catherine Lalonde

Nongma Evariste Sawadogo is a trained midwife. He joined Family Care International (FCI) two years ago as a program officer and managed Burkina Faso’s reproductive, maternal, newborn and child health (RMNCH) projects. He will soon join Management Sciences for Health (MSH) as a member of the recently launched FCI Program.

Nongma is passionate about improving RMNCH in his country and community. He works with community-based organizations, leads workshops, provides technical support to community health facilities, and evaluates projects to advance RMNCH and to ensure the greatest impact for women and children.

Continue reading “Nongma Sawadogo, midwife and reproductive health champion in Burkina Faso”

Maternal and newborn health in the hands of midwives

Amy Boldosser-Boesch is the Interim President and CEO at Family Care International. This article originally appeared on the Maternal Health Task Force blog as part of a series for the Global Maternal and Newborn Health Conference, October 2015 in Mexico City.

The year 2015 has been one of dramatic movement for global maternal and newborn health—from the end of the Millennium Development Goals to the beginning of a universal and even more ambitious global agenda. The Global Maternal and Newborn Health Conference is a key moment to examine how the Sustainable Development Goals will help ensure and improve quality of care, integration and equity. I’m pleased to see on the conference program a focus on midwives, a key partner in turning the conference themes and focus into a reality for women and their families everywhere.

At this crossroads moment in global development, it’s a travesty that the countries burdened with 92% of the world’s maternal and newborn deaths have only 42% of the world’s midwives, nurses and doctors. Even though we have the medicines and the technology to make sure no woman or newborn dies from preventable causes, a person’s place of residence often still determines whether–and how–she will live or die. This is simply unacceptable. Fortunately, skilled midwives can prevent up to two-thirds of maternal and newborn deaths, and in doing so can turn around health care in their communities, according to UNFPA’s State of the World’s Midwifery Report 2014.

Burkinabé midwives gather to discuss advocacy for supportive midwifery policies using data from the State of the World’s Midwifery Report 2014.
Burkinabé midwives gather to discuss advocacy for supportive midwifery policies using data from the State of the World’s Midwifery Report 2014.

Continue reading “Maternal and newborn health in the hands of midwives”

Interview with Salimata Sourgou, Burkina Faso program assistant

Salimata Sourgou comes from Ouagadougou, Burkina Faso. She joined FCI as an administrative assistant in our office in Ouagadougou, and since last year, she has worked as a program assistant on the Mobilizing Advocates from Civil Society (MACS) project, which brings together civil society organizations and equips them with skills to be effective advocates. We spoke with her ​​about her work as a member of the FCI Burkina Faso team.

Photo by Catherine Lalonde
Photo by Catherine Lalonde

Continue reading “Interview with Salimata Sourgou, Burkina Faso program assistant”

Discovering advocacy successes through participatory evaluation

By Catherine Lalonde and Kathleen Schaffer

Catherine Lalonde is the senior program officer for the Francophone Africa program, and Kathleen Schaffer is the senior program officer for the Anglophone Africa program.

This post is the second in a blog series on the evaluation of FCI’s multi-year advocacy project, Mobilizing Advocates from Civil Society. Find the first post here.

Evaluating advocacy is far from simple. Advocacy is not straightforward, as advocates often need to readjust strategies to influence decision-makers when government leaders and policies change. So it’s often difficult to attribute a policy success to a specific advocacy effort. We are grappling with these challenges firsthand as we evaluate our advocacy project Mobilizing Advocates from Civil Society (MACS).

Continue reading “Discovering advocacy successes through participatory evaluation”

Reflections on evaluating advocacy

Catherine Lalonde is the senior program officer for the Francophone Africa program.

Saving the lives of women and children around the world is a team effort. It takes the voices of community and religious leaders, health professionals, concerned citizens, young people, and impassioned activists to effect change. Prioritizing women’s and children’s health requires sustained advocacy.

Yet, determining whether certain advocacy efforts are actually achieving desired results—evaluating an advocacy program—is challenging. Through the evaluation of our Mobilizing Advocates from Civil Society (MACS) project, which brings together civil society organizations and equips them with skills to be effective advocates, we are reflecting on what it means to evaluate advocacy.

Continue reading “Reflections on evaluating advocacy”

Budget accountability in the midst of the Burkina Faso revolution

By Manuela Garza

Manuela Garza is an independent consultant and is co-founder of Colectivo Meta. She is currently engaged as a consultant to FCI’s Mobilizing Advocates from Civil Society (MACS) project, on which she works to build the budget analysis skills of health-focused civil society organizations in Burkina Faso.

For the past seven years, it was my good fortune to work at a job that allowed me to work with brave and committed activists in interesting and beautiful places. As a staff member of the International Budget Partnership, I found myself in Mombasa, Kenya, where ordinary citizens conducted ‘social audits’ to claim their communities’ fair share of government financial resources; in Abbottabad, Pakistan, where 500 women and men voiced their priorities for spending of earthquake rehabilitation funds; in Beijing, where civil society groups were trained to pursue budget transparency and accountability in a context where silence rules; and in Abbra, a remote region in the Philippines, where rural villagers have advocated for and achieved truly participatory budgeting.

In recent months, FCI’s MACS initiative has been working in Burkina Faso to strengthen the capacity of civil society groups to effectively advocate for more and smarter spending of public funds to improve reproductive, maternal, newborn, and child health in their communities. Last October, I was engaged, together with my Malian colleague Boubacar Bougodogo and Burkinabé budget researcher Hermann Doanio, to develop and facilitate a weeklong workshop to train grassroots advocates to understand and engage with public budgets. We arrived in Ouagadougou, Burkina’s capital, on a calm and warm West African evening, all of us ready with our slides on the budgeting process, our spreadsheets, our budget calculation formulas, and our case studies. Business as usual, or so we thought.

Little did we know that, in the course of that week, the citizens of Burkina Faso would overthrow the dictator who had been ruling the country for the past 27 years. Thousands of people (young people, mostly) took to the streets with a very clear message for President Blaise Campaoré: they wanted him out, for good. They were no longer willing to tolerate corruption and abuse of power, they declared: Burkina is ready for democracy.

In the midst of these historic events, you may be wondering, what did our Burkinabé colleagues, who had put this week aside for budget training, do? Was the workshop still relevant during these revolutionary days? Of course, every participant was closely watching the dramatic events taking place outside the training venue; each participant was concerned and worried about what they would mean for their families and their country. At the same time, however, they remained committed to take full advantage of this unique opportunity to learn about a new tool that will enable them to carry out evidence-based advocacy. They stuck around, they learned, and they questioned; they talked about their country, about change, and about what these new skills could help them achieve. They discussed the potential for how things could change, including in the way that the government sets priorities and spends public money— that is, the people’s money!

Civil society plays a key role in ensuring that governments prioritize spending on women’s and children’s health.
Civil society plays a key role in ensuring that governments prioritize spending on women’s and children’s health.

Is budget accountability still relevant in a context of earthshaking change? My experience says that it is. Revolutions are tricky things: countries and their institutions can change either for better or for worse, and conditions may take a long time to stabilize. If change is managed wisely and stability returns quickly, as seems to be happening in Burkina, revolution can provide an opportunity for a fundamental shift in the balance of power—toward the people. This can vastly increase the possibility of reshaping inefficient and corrupt institutions, of fostering new structures that institutionalize transparency and accountability. In a country like Burkina Faso, accountability for public resources is an essential element of overall accountability.

In this context, investing in building the skills of civil society groups is crucial, because the significance and sustainability of positive change largely depends on a well-organized and well-prepared civil society. These are the times when advocates and grassroots organizations most need support, when citizens most need to develop new knowledge and skills in civic participation, when accountability and participation-related processes are more necessary than ever. The MACS project is doing just that, and FCI’s local partners in Burkina Faso will continue to arm themselves with new tools such as budget analysis, so that their advocacy has more impact, their voices are heard, and they can be effective forces for real, sustainable change.

Good luck to them and to Burkina Faso–a country that many people cannot even locate on a map but which has a lot to teach us when it comes to citizen power!

 

Advocacy success story: Burkina Faso broadens access to misoprostol, an essential maternal health medicine

By Brahima Bassane, MD

[Version française ci-dessous]

Brahima Bassane, FCI’s national director in Burkina Faso, is a public health physician.

Postpartum hemorrhage (PPH) — excessive, uncontrolled bleeding after childbirth —remains the leading cause of maternal death worldwide.  In countries like Burkina Faso, where many births still occur at home, the drug misoprostol offers a number of advantages for preventing and treating PPH because (unlike oxytocin, considered the ‘gold standard’ medicine for PPH) it can be easily administered and does not require cold storage. In settings with limited infrastructure and lack of skilled birth attendants, misoprostol may be a woman’s only chance for surviving PPH.

Access to high-quality medicines is part of every citizen’s right to the highest attainable standard of health. But in spite of misoprostol’s proven safety and efficacy, decision-makers in some countries have been reluctant to authorize its widespread availability, or are unaware of the available evidence. Many governments have not included misoprostol in their national essential medicine list (EML), which is often used as the basis for importation, distribution, and marketing of medicines for the public health system.

FCI works to support wider understanding, acceptance, and use of misoprostol for PPH. This year in Burkina Faso, our efforts — with a range of advocacy partners — to persuade government officials to deem misoprostol for PPH an essential medicine were successful. This success story offers a potential model for effective, collaborative, focused advocacy in other countries where misoprostol’s lifesaving benefits are not yet broadly available.

Our advocacy began in earnest last September, when FCI convened a meeting  to share the latest research on misoprostol for PPH and to develop advocacy strategies that would convince the government to take action. These committed and motivated maternal health champions called for the widespread availability of misoprostol, stating that the inclusion of misoprostol in the national EML was an urgent national priority.

Following the meeting, a small advisory committee was assigned the task of reaching key government decision makers. The committee submitted a letter and technical note to the Director-General of Pharmacy, Medicines, and Laboratories (DGPML) requesting inclusion of misoprostol on the EML. A DGPML technical committee then reviewed the submitted application, gathering all available evidence on misoprostol. During this review period, FCI and our partners met again with the Director-General of the DGPML, who stated his support for misoprostol as a critical tool for reducing the burden of PPH in Burkina Faso. FCI and partners also met with the Secretary-General of the Ministry of Health, who affirmed the government’s responsibility for ensuring the availability of misoprostol for PPH at public health facilities. He also came out in support of misoprostol distribution at the community level, and recommended ongoing supervision and training to ensure its correct use.

In February of this year, all of these advocacy efforts paid off: the 2014 revision of the national EML (Liste Nationale Des Medicaments et Consommables Medicaux Essentials, Edition 2014) includes misoprostol both for prevention and for treatment of PPH.

While this is an important step in making misoprostol available in the government health system, FCI and our partners will continue advocating and working to ensure that all women have access to a uterotonic , like misoprostol or oxytocin, for effective prevention and treatment of postpartum hemorrhage. These efforts are critical for countries’ efforts to fulfill the promise of MDG 5 and put an end, once and for all, to preventable maternal death.

Learn more about FCI’s work on misoprostol for PPH here.

To join an online community on misoprostol for PPH, please click here.

 

Réussite exemplaire du plaidoyer : Le Burkina Faso élargit l’accès au misoprostol, un médicament essentiel de la santé maternelle

Par Brahima Bassane, MD– médecin en titre

Directeur national de FCI au Burkina Faso, Brahima Bassane est médecin de santé publique.

L’Hémorragie du post-partum (HPP) — des saignements excessifs, difficiles à arrêter survenant après l’accouchement — demeure la principale cause de décès maternels à travers le monde. Dans des pays tels que le Burkina Faso où un nombre important des accouchements surviennent encore à domicile, le médicament misoprostol fournit nombre d’avantages pour la prévention et le traitement de l’HPP dans la mesure où il peut être facilement administré et ne nécessite pas une conservation à dans un réfrigérateur (contrairement à l’ocytocine qui est considérée comme le médicament ‘de référence’ pour l’HPP).Le misoprostol peut représenter la seule chance de survie d’une femme en proie à l’HPP dans les milieux communautaires qui disposent d’un nombre insuffisant de centres de santé et d’accoucheuses qualifiées.

L’accès à des médicaments de haute qualité est un des droits de chaque citoyen pour lui permettre de jouir du meilleur état de santé possible. Toutefois, en dépit de l’innocuité et de l’efficacité reconnues du misoprostol, les décideurs ont été dans certains pays, réticents à autoriser sa mise à disposition généralisée ou ils ignorent les données disponibles. Plusieurs gouvernements n’ont pas inclus le misoprostol dans leur liste des médicaments essentiels (LME) qui est souvent utilisée comme critère pour l’importation, la distribution et la commercialisation de médicaments pour le système de santé publique.

FCI œuvre en vue de soutenir une meilleure compréhension, acceptation et utilisation du misoprostol pour l’HPP. Au Burkina Faso, nos initiatives —de concert avec un éventail de partenaires du plaidoyer —visant à convaincre cette année les responsables gouvernementaux de considérer le misoprostol pour l’HPP comme un médicament essentiel, ont été couronnées de succès. Cette réussite exemplaire fournit un modèle potentiel de plaidoyer efficace, mené en collaboration et bien ciblé dans d’autres pays où les avantages salvateurs du misoprostol ne sont pas encore largement disponibles.

Notre plaidoyer a véritablement débuté en septembre 2013 lorsque FCI a organisé une réunion en vue de partager les résultats des toutes dernières recherches sur le misoprostol pour l’HPP et de mettre au point des stratégies de plaidoyer qui convaincraient le gouvernement à prendre les bonnes décisions. Ces défenseurs engagés et motivés de la santé maternelle se sont prononcés pour la mise à disposition généralisée du misoprostol en indiquant que l’inclusion du misoprostol dans la Liste nationale des médicaments essentiels était une priorité nationale.

Suite à la réunion, la tâche de prendre contact avec les principaux décideurs gouvernementaux a été confiée à un petit comité consultatif. Le comité a présenté au Directeur Général de la Pharmacie, du Médicament et des Laboratoires (DGPML) une lettre et une note technique sollicitant l’inclusion du misoprostol dans la LME. Un comité technique de la DGPML a ensuite examiné la demande soumise en recueillant toutes les données disponibles relatives au misoprostol. Au cours de cette période d’examen, FCI et nos partenaires se sont réunis avec le Directeur Général de la GPML qui a exprimé son soutien pour le misoprostol comme outil crucial pour alléger le fardeau de l’HPP au Burkina Faso. Cette équipe restreinte de FCI et ses partenaires s’est également réunie avec le Secrétaire Général du Ministère de la Santé qui a affirmé la responsabilité du gouvernement à assurer la disponibilité du misoprostol pour l’HPP dans les établissements de santé. Il s’est également prononcé en faveur de la distribution du misoprostol jusqu’à l’échelle communautaire  tout en recommandant une supervision suivie et la formation afin de garantir son utilisation adéquate.

En février au cours de cette année 2014, toutes ces initiatives du plaidoyer ont porté leurs fruits : la révision en 2014 de la LNMCE (Liste Nationale Des Médicaments et Consommables Médicaux Essentiels, Édition 2014) comprend notamment le misoprostol pour la prévention ainsi que le traitement de l’HPP.

Bien que la mise à disposition du misoprostol dans le système public de santé constitue une étape importante, FCI et nos partenaires continueront à plaider et à œuvrer pour veiller à ce que toutes les femmes aient accès à un utérotonique tel que le misoprostol ou l’ocytocine pour une prévention et un traitement efficaces de l’hémorragie du post-partum. Ces initiatives sont cruciales pour les efforts des pays à tenir leur promesse pour l’OMD5 et à définitivement mettre un terme aux décès maternels évitables.

Trouvez de plus amples informations relatives aux travaux de FCI sur le misoprostol pour l’HPP.

Veuillez cliquer ici pour intégrer une communauté virtuelle sur le misoprostol pour l’HPP.