Feasibility of the eight or more contacts of the WHO new antenatal care model in Cote d'Ivoire: an antenatal care providers' perspective.

This paper examines the feasibility of the eight or more ANC contacts in Cote d'Ivoire through a qualitative study among twenty antenatal care providers through individual interviews. The eight or more ANC contacts were found useful as they will allow a better follow up of the pregnancy. Main barriers were: the lack of training on the 2016 WHO ANC model, the late initiation of ANC and the fear of increased workload. Drivers identified were: availability of supplies, adoption and dissemination of the new guidelines, assignment of antenatal care providers in underserved area, digitization of the mother and child health handbook, pregnant women and community engagement, intensification of communication for behavior change and a good relationship provider-pregnant woman-community. To ensure appropriate design and effective delivery of the eight or more ANC contacts, attention should be paid to barriers and facilitators identified.

[Technical support and the immunization program performance in Côte d'Ivoire]. / Assistance technique et performance du programme de vaccination en Côte d'Ivoire.

OBJECTIVE: The objective of this study is to analyze the effect of a technical support aiming to improve vaccine program performance in the 10 health districts (HDs) of Côte d'Ivoire, in which the largest numbers of children not vaccinated against measles were registered. METHOD: These HDs benefited between June 2016 and May 2017, from four quarterly supportive supervisions along with technical support in health logistics and data management and quality. We had followed the evolution of the key indicators in each targeted HD and compared them to the other HDs. RESULTS: The measles containing vaccine coverage (MCVC) had increased and exceeded 80% in 8 out of 10 the targeted HDs. The increase of this MCVC was higher in the targeted HDs (12 points versus 3 points). The number of children not vaccinated against measles had been reduced by 66% and in 8 out of 10 HDs. The global drop-out rate decreased by 13 points in the targeted HDs, whereas it increased by 1 point in the other HDs.The timeliness increased and was more than 80% in 9 of the 10 targeted HDs. The increase of this timeliness was better in the targeted HDs (35 points versus 25 points). The overall quality index was higher in the targeted HDs (90% versus 82%) and the score per component for targeted HDs was better. CONCLUSION: This technical support has have an positive effect on the vaccine performance of targeted HDs. The current challenge is to scale up this type of intervention to all districts in the country.