Morbidity management for hard to reach populations in insecure areas in Burkina Faso: analysis of barriers and determination of the resilience of the health system
The study aims to identify the most effective approaches for case management and delivery of surgical services for IDPs and migrants suffering from LF and/or trachoma in security compromised areas. Barriers to reaching morbidity patients will be assessed, in addition to determinants of the institutionalizatoin of NTD morbidity management within the national health system. Research aims will be addressed through the following key activities: document review and direct inspection protocols to determine health facilities' ability to provide MMDP services; active case finding including creation of WhatsApp groups and SMS messaging to help keep track of patients and refer them to care; key informant interviews with health workers and community leaders to assess behavior change communication strategies for raising awareness among affected individuals; one-on-one interviews and focus group discussions with patients to understand barriers to care; and stakeholder engagement to increase buy-in and identify ways to operationalize MMDP services within national program.
The study concluded in June, 2021. In addition to updated case census results for hydrocele, lymphedema and TT in the study areas, the following conclusions were reached, among others:
Insecurity has aggravated geographical and economic barriers to care, especially for vulnerable patients such as those suffering from NTDs.
The health system infrastructure (including ambulances and supply warehouses) are particularly vulnerable to attack, which further exacerbates the effects on the patients most in need of care. Patients from several villages had no access to care because they are completely inaccessible due to insecurity.
There is an urgent need to strengthen the skills of health workers to manage cases of LF and TT in regions marked by insecurity, and to shore up facility staff and supply capacity in these areas.
The burden of NTDs, particularly the number of NTD cases in host regions, has changed with the arrival of internally displaced persons