Task sharing for family planning services, Burkina Faso

Problem: In Burkina Faso, the coverage of services for family planning is low due to shortage of qualified health staff and limited access to services.Approach:Following the launch of the Ouagadougou Partnership, an alliance to catalyse the expansion of family planning services, the health ministry created a consortium of family planning stakeholders in 2011. The consortium adopted a collaborative framework to implement a pilot project for task sharing in family planning at community and primary health-care centre levels in two rural districts. Stakeholders were responsible for their areas of expertise. These areas included advocacy; monitoring and evaluation; and capacity development of community health workers (CHWs) to offer oral and injectable contraceptives to new users and of auxiliary nurses and auxiliary midwives to provide implants and intrauterine devices. The health ministry implemented supportive supervision cascades involving relevant planning and service levels.Local setting In Burkina Faso, only 15% (2563/17 087) of married women used modern contraceptives in 2010.Relevant changes Adoption of new policies and clinical care standards expanded task sharing roles in family planning. The consortium trained a total of 79 CHWs and 124 auxiliary nurses and midwives. Between January 2017 and December 2018, CHWs provided injectables to 3698 new users, and auxiliary nurses or midwives provided 726 intrauterine devices and 2574 implants to new users. No safety issues were reported.Lessons learnt The pilot project was feasible and safe, however, financial constraints are hindering scale-up efforts. Supportive supervision cascades were critical in ensuring success

Risk factors for post-cesarean section surgical site infections among patients in the Philippine General Hospital: A case control study

OBJECTIVE: To determine the risk factors and the current actual incidence of surgical site infection (SSI) following a cesarean delivery in te Philippine General Hospital.METHODS: In a case-control study, 729 patients admitted at PGH's post-partum clinic, emergency room and obstetrical wards, from November 2007- May 200, were interviewed using a data sheet from that included mother's age, gravidity and parity, body mass index, smoking history, steroid and illicit drug use, previous surgeries, co-morbidities and questions on personal hygiene, as part of the ongoing infection surveillance. Operation-related and obstetric-related variables were documented through review of medical records. Definitions of the Centers of Disease Control of surgical site infection were used.RESULTS: Thirteen percent of patients developed SSI among 713 patients recruited in the study. Although univariate analysis of risk factors did not show statistically significant results, steroid use , smoking and illicit drug use, previous surgery, anemia prior to operation, longer duration of labor and rupture of membranes and longer duration of operation appear to predispose patients to surgical site infections after cesarean section. The incidence of SSI was significantly lower in patients with hypertensive complications.