title: Readiness of district and regional hospitals in Burkina Faso to provide caesarean section and blood transfusion services: a cross-sectional study.
abstract: BACKGROUND
  Health centres and hospitals play a crucial role in reducing maternal mortality and morbidity by offering respectively Basic Emergency Obstetric and Newborn Care (BEmONC) and Comprehensive Emergency Obstetric and Newborn Care (CEmONC). The readiness of hospitals to provide CEmONC depends on the availability of qualified human resources, infrastructure like surgical theatres, and supplies like drugs and blood for transfusion. We assessed the readiness of district and regional hospitals in Burkina Faso to provide two key CEmONC functions, namely caesarean section and blood transfusion. As countries conduct EmONC needs assessments it is critical to provide national and subnational data, e.g. on the distribution of EmONC facilities as well as on facilities lacking the selected signal functions, to support the planning process for upgrading facilities so that they are ready to provide CEmONC.
  
  
  METHODS
  In a cross-sectional study we assessed the availability of relevant health workers, obstetric guidelines, caesarean section and blood transfusion services and experience with quality assurance approaches across all forty-three (43) district and nine (9) regional hospitals.
  
  
  RESULTS
  The indicator corresponding to one comprehensive emergency care unit for 500,000 inhabitants was not achieved in Burkina Faso. Physicians with surgical skills, surgical assistants and anaesthesiologist assistants are sufficiently available in only 51.2%, 88.3% and 72.0% of district hospitals, respectively. Two thirds of regional and 20.9% of district hospitals had blood banks. Most district hospitals as opposed to only one third of regional hospitals had experience in maternal death reviews.
  
  
  CONCLUSIONS
  Our findings suggest that only 27.8% of hospitals in Burkina Faso at the time of the study could continuously offer caesarean sections and blood transfusion services. Four years later, progress has likely been made but many challenges remain to be overcome. Information provided in this study can serve as a baseline for monitoring progress in district and regional hospitals.
authors.affiliation: Centre Muraz, Bobo-Dioulasso, Burkina Faso, PO Box 390, Bobo-Dioulasso, Burkina Faso. georgesday@yahoo.fr.
authors.forename: Georges Dayitaba
authors.initials: GD
authors.lastname: Compaoré
authors.forename: Issiaka
authors.initials: I
authors.lastname: Sombié
authors.forename: Rasmané
authors.initials: R
authors.lastname: Ganaba
authors.forename: Sennen
authors.initials: S
authors.lastname: Hounton
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meda
authors.forename: Vincent De
authors.initials: VD
authors.lastname: Brouwere
authors.forename: Matthias
authors.initials: M
authors.lastname: Borchert
mesh_terms: D000776:Anesthesiology; D001771:Blood Banks; D001803:Blood Transfusion; D002050:Burkina Faso; D002585:Cesarean Section; D003430:Cross-Sectional Studies; D004630:Emergencies; D005260:Female; D013502:General Surgery; D006285:Health Planning; D006297:Health Services Accessibility / Q000458:organization & administration; D006767:Hospitals, District / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008880:Midwifery; D009774:Obstetrics / Q000458:organization & administration* / Q000592:standards; D010564:Personnel, Hospital / Q000600:supply & distribution*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011785:Quality Assurance, Health Care; D019035:Rural Health Services / Q000458:organization & administration* / Q000592:standards; D000078329:Workforce