Performance in community-based management of childhood illnesses and factors associated with its effective implementation in Burkina Faso

Background Burkina Faso gives high priority to improving maternal and child health. Several community interventions have been developed following the adoption of primary health care. Following the adoption of free community care services and the recruitment of community health workers to strengthen community management of childhood illnesses, we conducted a formative performance evaluation and a search for factors associated with its effective application. Methods We conducted a descriptive and analytical cross-sectional study using data collected from March 19 to 30, 2023 and January 12 to 30, 2024 in the health districts of Boussé and Boussouma in Burkina Faso through a survey, focus groups and a literature review, then analyzed with SPSS 25 and Nvivo. Results Community management of childhood illnesses is implemented in various ways in different health districts. Data from 2017 to 2022 clearly shows that the proportion of malaria cases confirmed with rapid diagnostic tests and treated at community level has evolved globally. On the other hand, management of diarrhea and pneumonia is inadequate. Factors such as the health district of origin, difficulties faced in transporting inputs and the regularity of Community based health workers premium payments determines significantly the availability of curative care in the community. Conclusions Despite the measures to provide free care and recruit CBHWs to support the implementation of the Community Integrated Management of Childhood Illness, health facility adherence and a number of other essential factors are hampering the availability of basic care in the desired community. There is an inequity of access to community health care reducing the impact of free health care and the recruitment of community-based health workers on certain populations. Trial registration This study used data generated by the system. Surveys and data extraction were carried out after obtaining authorization from the Ministry of Health's Health Research Ethics Committee.