Burkina Faso - WHO · Burkina Faso Country profile For Demographic and Health Surveys, the years...

WHO Director-General Roundtable with Women Leaderson Millennium Development Goal 5

Burkina FasoCountry profileFor Demographic and Health Surveys, the years refer to when the Surveys were conducted. Estimates from the Surveys refer to three or five years before the Surveys..

Lead the fight for MDG 5

4. Causes of maternal deaths, 1997–2002A maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy from any cause related to the pregnancy or its management but not from accidental or incidental causes. The most frequent causes of maternal deaths in Africa (for 1997–2002) were haemorrhage (uncontrolled bleeding), sepsis or infections including HIV, hypertensive disorders (high blood pressure) and other causes. There are no country-specific data for Burkina Faso.

Burkina Faso and the world

5. Total fertilityThe total fertility is the average number of children that would be born to a woman over her lifetime. The total fertility rate can be separated into the births that were planned (wanted total fertility rate) and those that were unintended (unwanted total fertility rate). According to a survey conducted in 2003 the total fertility rate was about 6 per woman.

Demographic and health data

1. Maternal mortality ratio: global, regional and country data, 2005

A maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy from any cause related to the pregnancy or its management but not from accidental or incidental causes. The maternal mortality ratio is the number of maternal deaths per 100 000 live births per year. The ratio in Burkina Faso is 700 per 100 000 live births versus an average of 900 per 100 000 live births in sub-Saharan Africa and an average of 400 per 100 000 live births globally.

2. Lifetime risk of maternal death (1 in N) 2005

The lifetime risk of maternal death is the estimated risk of an individual woman dying from pregnancy or childbirth during her adult lifetime based on maternal mortality and the fertility rate in the country. The lifetime risk of dying from pregnancy-related causes in Burkina Faso is 1 in 22, higher than the average of 1 in 26 for Africa and the global figure of 1 in 92.

Source: Maternal mortality in 2005: estimates developed by WHO, UNICEF, UNFPA and the World Bank. Geneva, World Health Organization, 2007 (http://www.who.int/reproductive-health/publications/maternal_mortality_2005/index.html).

Source: Khan KS et al. WHO analysis of causes of maternal death: a systematic review. Lancet, 2006, 367:1066–1074.

Sources: Making Pregnancy Safer country profiles [online database]. Geneva, World Health Organization, in press (Department of Making Pregnancy Safer; http://www.who.int/making_pregnancy_safer/en).Demographic and Health Surveys [web site]. Calverton, MD, MEASURE DHS, Macro International Inc. (http://www.measuredhs.com/aboutsurveys/search/start.cfm).

3. Total population (in thousands)1 14 359 (2006) Lifetime risk of maternal death (1 in N)2 22 (2005) Total maternal deaths2 4 300 (2005)

Sources: 1World Health Organization 2008, World Health Statistics 2008 Geneva, Switzerland (http://www.who.int/whosis/whostat/EN_WHS08_Full.pdf). 2Maternal mortality in 2005: estimates developed by WHO, UNICEF, UNFPA and the World Bank. Geneva, World Health Organization, 2007 (http://www.who.int/reproductive-health/publications/maternal_mortality_2005/index.html).

Source: Maternal mortality in 2005: estimates developed by WHO, UNICEF, UNFPA and the World Bank. Geneva, World Health Organization, 2007 (http://www.who.int/reproductive-health/publications/maternal_mortality_2005/index.html).

0.70.8

5.75.1

1998–99 2003

Wanted total fertility rate Unwanted total fertility rate

7

6

5

4

3

2

1

0Tota

l fer

tilit

y ra

te (

per

wo

man

)

Other causes30%

Anaemia 4%

Haemorrhage34%

Abortion 4%

Obstructed labour 4%

Hypertensive disorders 9%

Sepsis or Infections,including HIV 16%

Afr

ica

700

900

400

0

200

400

600

800

1000

De

ath

s p

er

10

0 0

00

liv

e b

irth

s

Sub-Saharan Africa WorldBurkina Faso

1/221/26

1/92

0

1/100

1/50

3/100

1/25

1/20

Lif

etim

e ri

sk o

f d

eath

(1

in N

)

Africa WorldBurkina Faso

Burkina Faso

9. Adolescent pregnancy rate by urban versus rural location

According to surveys conducted in 1998–99 and 2003, the overall change in the adolescent pregnancy rate is mainly attributable to the change in rural areas.

8. Adolescent pregnancy rate by age for women 15–19 years old

Adolescent pregnancy is pregnancy in an adolescent girl (girls 10–19 years old). The adolescent pregnancy rate indicates the proportion of adolescent girls who become pregnant among all girls in the same age group in a given year.

7. Perinatal mortality rate, 2003Perinatal mortality refers to deaths of fetuses in the womb and of newborn babies early after delivery. It includes (1) the death of a fetus in the womb after 22 weeks of gestation and during childbirth and (2) the death of a live-born child within the first seven days of life. The perinatal mortality rate reflects the availability and quality of both maternal and newborn health care.

Rural90%

Urban10%

6. Proportions of births by urban versus rural location

Among the women interviewed in a survey conducted in 1998–1999, about 90% of births occurred in rural areas.1

The total number of births (in thousands): 628 (2005)2

Sources: 1Making Pregnancy Safer country profiles [online database]. Geneva, World Health Organization, in press (Department of Making Pregnancy Safer; http://www.who.int/making_pregnancy_safer/en).Demographic and Health Surveys [web site]. Calverton, MD, MEASURE DHS, Macro International Inc. (http://www.measuredhs.com/aboutsurveys/search/start.cfm).

2World population prospects: the 2006 revision. CD-ROM edition – extended dataset in Excel and ASCII formats. New York, United Nations Department of Economic and Social Affairs, Population Division, 2007 (United Nations publications, ST/ESA/SER.A/266).




2

5.2

3.5

5.75.8

3.2

6.8

0

2

4

6

8

10

12

Total Urban Rural

1998–99 2003

% o

f w

om

en (

15-1

9 ye

ars

old

) p

reg

nan

t w

ith

th

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firs

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2.6

5.8

10 9.1

0.7 1.7

7.1

11

9.3

0

2

4

6

8

10

12

15 16 17 18 19

% o

f w

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15-1

9 ye

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old

) p

reg

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t w

ith

th

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firs

t ch

ild

2003

1998–99

Age (years)

10. Adolescent pregnancy by subregionAdolescent pregnancy rates vary in Burkina Faso, with the lowest overall rates in Ouagadougou and the highest in the eastern and northern regions. Adolescent pregnancy rates can vary for many reasons, including cultural norms, socioeconomic deprivation, education, access to sexual health information and to contraceptive services and supplies.


3.1

6.8

4.6

5.85.2

2.7

6.7

8.8

4.8 5.1

0

2

4

6

8

10

Ouagadougou North East West Central/South

1998–99 2003

% o

f w

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15-1

9 ye

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old

) p

reg

nan

t w

ith

th

eir

firs

t ch

ild

15.1

19.5

19.0

19.6

13.7

23.9

34.6

42.9

33.3

0

10

20

30

40

50

Total Urban Rural

per

100

0 p

reg

nan

cies

S ti ll b irth ra te E a rly n e o n a ta l d e a th ra te P e rin a ta l m o rta lity


12. Family planning: modern contraceptive use by age group

In general, over time, contraceptive prevalence rate increased in all age groups, although the rate remains low.

16. Utilization of skilled birth attendants

A skilled birth attendant is an accredited health professional – such as a midwife, doctor or nurse – who has been educated and trained to proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complications among women and newborns. All women should have access to skilled care during pregnancy and at delivery to ensure that complications are detected and managed. Many women continue to deliver without skilled attendants. For example, a survey conducted in 2003 showed that only 37.9% of live births were attended by a skilled attendant at delivery.

14. Contraceptive use by subregionAn increasing number of women were using modern contraceptives in all regions of Burkina Faso in surveys conducted in 2003 compared with those conducted in 1998–99. The use of modern contraceptives is substantially higher in Ouagadougou than in all other regions of Burkina Faso.

15. Antenatal careAntenatal care visits (ANC) include all visits made by pregnant women for reasons relating to pregnancy. According to a survey conducted in 2003, approximately 73% of women received ANC for their latest pregnancy that ended in a live birth. Of the pregnancies that ended in live births, approximately 73% were given ANC by a skilled provider at least once.

13. Contraceptive use by urban versus rural location

Modern contraceptive methods include oral and injectable hormones, intrauterine devices, diaphragms, hormonal implants, female and male sterilization, spermicides and condoms. In Burkina Faso, a survey conducted in 2003 showed that 8.8% of married women were using modern contraceptive methods. The overall rate is still very low and urban and rural areas differ widely.

Intervention coverage for mothers and newborns

11. Unmet need for family planning 2003 29%






3

The unmet need for family planning is the proportion of all women who are at risk of pregnancy and who want to space or limit their childbearing but are not using contraceptives.Source: World contraceptive use 2007. New York, United Nations Department of Economic and Social Affairs, Population Division, 2007 (http://www.un.org/esa/population/publications/contraceptive2007/contraceptive2007.htm, accessed 18 August 2008).

% o

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mod

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cont

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15–19 20–24 25–29 30–34 35–39 40–44 45–49

.

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.

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–Age (years)

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.

4.8

8.8

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28.5

2.65.2

Burkina Faso 1998-99 Burkina Faso 2003

Burkina Faso

17. Utilization of skilled birth attendants by wealth quintile 2003

Whether a woman delivers with the assistance of a skilled attendant is highly influenced by how rich she is. In a survey conducted in 2003, 90.8% of women in the highest wealth quintile had a skilled attendant present at birth versus only 38.8% of women in the lowest wealth quintile.

21. Caesarean section by subregion

At the subregional level, according to the survey conducted in 2003, Ouagadougou reported the highest rate of births delivered by caesarean section, compared with all other regions.

19. Place of delivery

Delivery in a health facility can reduce maternal and neonatal death and morbidity. According to a survey conducted in 2003, 38.5% of women who were pregnant gave birth at a health facility, and most women gave birth at home.

20. Caesarean section rates by urban versus rural location

Caesarean section is a surgical procedure in which incisions are made through a woman’s abdomen and womb to deliver her baby. It is performed whenever abnormal conditions complicate vaginal delivery, threatening the life and health of the mother and/or the baby. According to a survey conducted in 2003, less than 1% (0.7%) of births were delivered by caesarean section in Burkina Faso. Low caesarean section rates could indicate an unmet need for access to adequate health system infrastructure, which needs to be met if maternal deaths are to be reduced. In developing countries the unmet need tends to be higher in rural than in urban areas.

18. Utilization of skilled birth attendants by subregion

The percentage of women giving birth with the assistance of a skilled attendant also varies greatly by region within Burkina Faso. In Ouagadougou, according to surveys conducted in 2003, the vast majority (95.3%) of women giving birth had the assistance of a skilled attendant, whereas the rates were much lower in all other regions.

22. Low birth weightBabies weighing less than 2500 g at birth are considered to have low birth weight. According to the survey conducted in 2003, of those babies who were weighed at birth, 4.2% were reported to weigh less than 2500 g (2.5 kg). Low-birth-weight babies often face severe short- and long-term health consequences and tend to have higher mortality and morbidity.




4




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25. Equity – gap in coverage of four major interventions by wealth quintile

This graph illustrates the gap in coverage of four key interventions (family planning, maternal and newborn care, immunization and treatment of childhood illness) by wealth. The coverage gap reflects the difference between the goal of universal coverage of everyone in these four intervention areas and actual coverage. Where the gap is larger, it means that there is less adequate coverage. The opposite indicates better coverage. The graph indicates that, in both the 1998–1999 and 2003 surveys, the coverage gap is highest for the poorest and is lowest for the richer members of society (wealthiest quintile). Overall, the coverage gap in the Demographic and Health Survey (DHS) in 2003 (52%) was lower (that is, improved coverage) compared with the 1998–1999 survey (61%). Achieving equity requires improving coverage levels in the poorest quintiles.

24. Prevention of mother-to-child transmission of HIVThe percentage of pregnant mothers living with HIV receiving antiretroviral drugs (ARVs) to prevent the transmission of HIV to their child (PMTCT) increased steadily by almost 40 percentage points between 2004 and 2006.

23. Anaemia in pregnancyAnaemia refers to abnormally low levels of haemoglobin (iron-containing oxygen proteins) in the blood. The percentage of pregnant women with low haemoglobin levels (less than 110 g/l) was 68.3% according to a survey conducted in 2003. Severe anaemia is an important contributing factor to maternal deaths due to haemorrhage during childbirth.

Equity

Resources

Source: Countdown to 2015. Tracking progress in maternal, newborn & child survival: the 2008 report. New York, United Nations Children’s Fund, 2008 (http://www.countdown2015mnch.org/index.php?option=com_content&view=article&id=68&itemid=61).

Source: WHO database on national health policies, 2008.

The work of at least 23 health workers (doctors, nurses or midwives) per 10 000 population is estimated to be necessary to support the delivery of the basic interventions required to achieve the Millennium Development Goals related to health. Globally, 57 countries have been identified with critical shortages below this minimum. These countries have a severe crisis in human resources for health. Of these 57 countries, 36 are in sub-Saharan Africa. Burkina Faso, with about 6 health workers (as defined above) per 10 000 population, is one of the countries facing this crisis daily, with mothers and children lacking access to proper maternal and child care, HIV/TB and malaria care, and sexual and reproductive health information and services, including skilled birth attendants.

The shortage is exacerbated by staff losses due to migration (in search of a better life) of skilled staff to high-income countries, leaving behind already impoverished health services and systems.

Increasing the human resources around the world and establishing a balance between the services needed and the personnel available, and their distribution, are key elements of a well-functioning health system and critical requirements for achieving Millennium Development Goals.

26. Reproductive health Yes Maternal health Yes

27. Financial flow (per capita expenditure on health, in US dollars) 2007 77

28. Human resources

Policies


Source: Countdown to 2015. Tracking progress in maternal, newborn & child survival: the 2008 report. New York, United Nations Children’s Fund, 2008 (http://www.countdown2015mnch.org/index.php?option=com_content&view=article&id=68&itemid=61)..

Source: Countdown to 2015. Tracking progress in maternal, newborn & child survival: the 2008 report. New York, United Nations Children’s Fund, 2008 (http://www.countdown2015mnch.org/index.php?option=com_content&view=article&id=68&itemid=61)..

30.6%

35.4%

2.3%

31.7%

Mild anaemia Moderate anaemia

Severe anaemia Non anaemic

Source: WHO Global Atlas of the Health Workforce [online database]. Geneva, World Health Organization, 2008 (www.who.int/globalatlas/autologin/hrh_login.asp).

5

Poorest 2nd 3rd 4th Wealthiest

%

20

0

40

60

80

100

Coverage gap (%)

1999DHS

2003DHS

61

1.8

31

52

2.3

37

Ratiopoorest/wealthiest

Differencepoorest-wealthiest (%)

2004 2005 20060

20

40

60

80

100

% p

reg

nan

t w

om

en li

vin

g w

ith

H

IV r

ecei

vin

g A

RV

s fo

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MT

CT

12

29

53

Burkina Faso

29. Ratification of treaties and support of international consensus

For further information, contact:

Sources: Ratifications and reservations [web site]. Geneva, Office of the United Nations High Commissioner for Human Rights, 2008 (http://www2.ohchr.org/english/bodies/ratification/index.htm). Report of the Fourth World Conference on Women, Beijing, 4–15 September 1995. New York, United Nations, 1996 (http://www.un.org/womenwatch/confer/beijing/reports). Report of the International Conference on Population and Development, Cairo, 5–13 September 1994. New York, United Nations, 1994 (http://www.un.org/popin/icpd/conference/offeng/poa.html).

Source: World Bank indicators [online database]. Washington, DC, World Bank, 2008 (http://ddp-ext.worldbank.org/ext/ddpreports/ViewSharedReport?&CF=&REPORT_ID=9147&REQUEST_TYPE=VIEWADVANCED&HF=N/CPP&WSP=N).

Fixed-line and mobile phone subscribers (per 100 population) 8 (2006)

Internet users (per 100 population) 0.6 (2006)

Roads paved (% of total roads) Unknown

Improved water source (% of population with access) 72 (2006)

Improved sanitation facilities (% of urban population with access) 41 (2006)

Convention on the Elimination of All Forms of Discrimination against Women Yes

Convention on the Rights of the Child Yes

International Covenant on Economic, Social and Cultural Rights Yes

International Conference on Population and Development Yes

Fourth World Conference on Women Yes

Child and Adolescent Health and DevelopmentTel: +41 22 791 3281E-mail: [email protected] site: www.who.int/child_adolescent_health/en

Reproductive Health and Research Tel: +41 22 791 3372E-mail: [email protected] site: www.who.int/reproductive-health

Making Pregnancy SaferTel: +41 22 791 3966E-mail: [email protected] site: www.who.int/making_pregnancy_safer/en

Immunization, Vaccines and BiologicalsTel: +41 22 791 4612E-mail: [email protected] site: www.who.int/immunization/en

Gender, Women and HealthTel: +41 22 791 2394E-mail: [email protected] site: www.who.int/gender

30. Other determinants of health: water, sanitation, communication and road networks

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