BURKINA FASO BACKGROUND INFORMATION
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Geography
Burkina Faso is a landlocked Sahel country that shares borders with six nations. It lies between the Sahara desert and the Gulf of Guinea, south of the loop of the Niger River. The land is green in the south, with forests and fruit trees, and semi-arid in the north. Most of central Burkina Faso lies on a savanna plateau, 198-305 meters (650-1,000 ft) above sea level, with fields, brush, and scattered trees. Burkina Faso’s game preserves - the most important of which are Arly, Nazinga, and Park W - contain lions, elephants, hippopotamus, monkeys, warthog, and antelopes.
Annual rainfall varies from about 100 centimeters (40 in) in the south to less than 25 centimeters (10 in.) In the extreme north and northeast, where hot desert winds accentuate the dryness of the region. Burkina Faso has three distinct seasons: warm and dry (November-March); hot and dry (March-May); and hot and wet (June-October). Rivers are not navigable.
Burkina Faso’s 10.4 million people belong to two major West African cultural groups, the Voltaic and the Mandé. The Voltaic are far more numerous and include the Mossi, which make up about one-half of the population. The Mossi claim descent from warriors who migrated to present-day Burkina Faso and established an empire that lasted more than 800 years. Predominantly farmers, the Mossi are still bound by the traditions of the emperor, the Moro Naba, who holds court in Ouagadougou.
Most of Burkina Faso’s people are concentrated in the south and center of the country, sometimes exceeding 48 persons per square kilometer (125/sq. Mi.). This population density, high for Africa, causes annual migration of hundreds of thousands of Burkinabč to Côte d’Ivoire and Ghana for seasonal agricultural work.
A plurality of Burkinabč adhere to traditional African religions. The introduction of Islam to Burkina Faso was initially resisted by the Mossi rulers. Christians, predominantly Catholics, are largely concentrated among the urban elite.
Few Burkinabč have had formal education. Schooling is free but not compulsory, and only about 29% of Burkina Faso’s primary school age children receive a basic education. The country’s sole institution of higher education, the University of Ouagadougou, was founded in 1974, and has a branch now in Bobo-Dioulasso.
Status of national policy
Family Planning: A National Family Planning Policy was adopted in 1984, repealing the 1920 law against contraception. The family planning program was established in 1985 in response to government recognition of family planning as an essential component of maternal and child health services.
AIDS: Since 1988, the government of Burkina Faso had adopted an overt and progressive approach towards the prevention of AIDS. In 1989, the National Committee in the Fight Against AIDS (CNLS) with l’Organisation Mondial de la Sante (OMS) developed a plan for a period of three years followed by a second three year plan. The CNLS will be developing a new strategic plan in 1997.
Description of service delivery
As of 1993, through the Ministere de la Sante et de l’Action Sociale (MSAS) , family planning services were provided in 90 clinical service delivery points (SDP’s) distributed throughout the country’s thirty provinces. Burkina Faso has adopted a primary health care strategy with a national health care system consisting of the following 5 levels:
(1) Poste de Sante Primaire (PSP): serves the population of each village and is staffed by two paramedical staff. They were fairly well developed until the 1984 revolution, but since then function at a reduced scale.
(2) Centre de Sante et de Promotion Sociale (CSPS): first level of care with certified personnel (nurse, auxiliary midwives). Provides all the family planning methods (including IUD where trained personnel are available) - 474 total CSPS
(3) Centre Medical (CM): first level referral. A doctor id theoretically available. Provides all services including surgical facilities. Offers all FP methods except sterilization- 54 total CM.
(4) Centre Hospitalier Regional (CHR): all family planning services provided including sterilization but only for therapeutic reasons - 9 total CHR.
(5) Hopital National (HN): 2 total (Ouagadougou et Bobo-Dioulasso)
Non-governmental family planning organizations:
1) Association Burkinabe pour le Bien-Etre Familiale (ABBEF)
Two clinics in major cities
Have also instituted special "youth clinic" and some small CBD programs
2) Association Pour L’Action Familiale (APAF) - natural family planning
3) L’Association Burkinabe des Sages Femmes (ABSF)
Professional association which has created a private clinic providing comprehensive reproductive health (prenatal, postnatal & well child care included) and Family Planning services. They have consulting physicians, a laboratory and are considering doing deliveries. Two physicians have been trained by AVSC in sterilization but only one is still available to provide this much requested service.
Training
According to one situation analysis conducted by the Population Council, the vast majority of family planning providers surveyed were midwives. Fifteen percent of those had no formal training in family planning, and only half of those trained had received training in counseling. Informal on-the-job training was cited as a common mode of compensating for the lack of structured training.
Of the clinics surveyed, half had only one staff member providing family planning. While most providers showed themselves to be technically competent when undertaking the medical counseling and examination procedures, they were unwillingness or unable to communicate information to clients. (See Literature Highlights: Burkina Faso Situation Analysis).
Restrictions
Permanent methods are neither discussed nor, it seems, available. No training or equipment has been provided for sterilization services as it has not been seen, to date at least (1993), as a priority of the Ministry. Injectable contraceptives can only be provided by physicians, which explains their unavailability in rural clinics where there is unlikely to be a physician on staff.
References: State Department Background Notes, Africa: Facts on File, REDSO Preliminary Reports
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