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Implementation Fidelity of the National Malaria Control Program in Burkina Faso

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  • Valéry Ridde
  • Thomas Druetz
  • Serge Poppy
  • Seni Kouanda
  • Slim Haddad

Abstract

Background: Every year 40,000 people die of malaria in Burkina Faso. In 2010, the Burkinabè authorities implemented a national malaria control program that provides for the distribution of mosquito nets and the home-based treatment of children with fever by community health workers. The objective of this study was to measure the implementation fidelity of this program. Methods: We conducted a case study in two comparable districts (Kaya and Zorgho). Data were collected one year after the program’s implementation through field observations (10 weeks), documentary analysis, and individual interviews with stakeholders (n = 48) working at different levels of the program. The analysis framework looked at the fidelity of (i) the intervention’s content, (ii) its coverage, and (iii) its schedule. Results: The program’s implementation was relatively faithful to what was originally planned and was comparable in the two districts. It encountered certain obstacles in terms of the provision of supplies. Coverage fidelity was better in Kaya than in Zorgho, where many community health workers (CHW) experienced problems with the restocking of artemisinin-based combination therapy and with remuneration for periods of training. In both districts, the community was rarely involved in the process of selecting CHWs. The components affected by scheduling all experienced successive implementation delays that pushed nets distribution and the initial provision of artemisinin-based combination therapies to the CHWs past the 2010 malaria season. Conclusions: The activities intended by the program were mostly implemented with good fidelity. However, the implementation was plagued by delays that probably postponed the expected beneficial effects.

Suggested Citation

  • Valéry Ridde & Thomas Druetz & Serge Poppy & Seni Kouanda & Slim Haddad, 2013. "Implementation Fidelity of the National Malaria Control Program in Burkina Faso," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-9, July.
    • Handle: RePEc:plo:pone00:0069865
    DOI: 10.1371/journal.pone.0069865
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    References listed on IDEAS

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    1. Pluye, Pierre & Potvin, Louise & Denis, Jean-Louis & Pelletier, Jocelyne & Mannoni, Chantal, 2005. "Program sustainability begins with the first events," Evaluation and Program Planning, Elsevier, vol. 28(2), pages 123-137, May.
    2. Ridde, Valéry, 2008. ""The problem of the worst-off is dealt with after all other issues": The equity and health policy implementation gap in Burkina Faso," Social Science & Medicine, Elsevier, vol. 66(6), pages 1368-1378, March.
    3. Gavin Yamey, 2011. "Scaling Up Global Health Interventions: A Proposed Framework for Success," PLOS Medicine, Public Library of Science, vol. 8(6), pages 1-5, June.
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    1. Thomas Druetz & Federica Fregonese & Aristide Bado & Tieba Millogo & Seni Kouanda & Souleymane Diabaté & Slim Haddad, 2015. "Abolishing Fees at Health Centers in the Context of Community Case Management of Malaria: What Effects on Treatment-Seeking Practices for Febrile Children in Rural Burkina Faso?," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-14, October.
    2. Druetz, Thomas & Kadio, Kadidiatou & Haddad, Slim & Kouanda, Seni & Ridde, Valéry, 2015. "Do community health workers perceive mechanisms associated with the success of community case management of malaria? A qualitative study from Burkina Faso," Social Science & Medicine, Elsevier, vol. 124(C), pages 232-240.

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