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To reduce child mortality in children younger than 5 years, Burkina Faso has been offering free care to this population of children since 2016. The free care program is aligned with the Integrated Management of Childhood Illness (IMCI) guidelines. Given that the number of studies that evaluated the competence of health-care workers (HCWs) during the free care program was limited, we assessed the adherence level of HCWs to the IMCI guidelines in the context of free care. This was a secondary data analysis. Data were obtained from a cross-sectional study conducted from July to September 2020 in 40 primary health-care centers and two district hospitals in the Hauts-Bassins region in Burkina Faso. Our analysis included 419 children younger than 5 years old who were consulted according to IMCI guidelines. Data were collected through direct observation using a checklist. The overall score of adherence of HCWs to IMCI guidelines was 57.8% (95% CI, 42.6–73.0). The mean adherence score of the evaluation of danger signs was 71.9% (95% CI, 58.7–85.1). The mean adherence score of following IMCI guidelines was significantly greater in boys (54.2%) compared with girls (44.6%; P < 0.001). Adherence scores of the performance of different IMCI tasks were significantly different across HCW categories. The overall adherence of HCWs to IMCI guidelines in the context of free care was greater than the adherence reported before the implementation of free care in Burkina Faso. However, this assessment needs to be performed nationwide to capture the overall adherence of HCWs to IMCI guidelines in the context of the free care program.
Financial support: This study was funded by the European Union through the PAASME project.
Authors’ addresses: Hervé B. N. Kpoda, Satouro Arsène Somé, Manituo Aymar Serge Somda, Bernard Eric Agodio Dabone, Soumeya Ouangraoua, Emmanuelle Sempore, Leticia Sakana, Alain Hien, Bernard Ilboudo, and Souleymane Sanon, Centre Muraz de Bobo-Dioulasso, Institut National de Santé Publique, Burkina Faso, E-mails: email@example.com, firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, email@example.com, and firstname.lastname@example.org. Mimbouré Yara, Richard Bakyono, Imelda Simboro, Herman Bazie, and Hermamn Badolo, Observatoire National de la Santé de la Population, Institut National de Santé Publique, Burkina Faso, E-mails: email@example.com, firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, and email@example.com. Patrick Ilboudo, African Population and Research Center, Nairobi, Kenya, E-mail: firstname.lastname@example.org. Ali Sie, Centre de Recherche en Santé de Nouna, Institut National de Santé Publique, Burkina Faso, E-mail: email@example.com. Elie Kabré, Laboratoire National de Santé Publique, Ouagadougou, Burkina Faso, E-mail: firstname.lastname@example.org. Clément Meda, UFR Sciences et Technique/Université Nazi Boni, Bobo-Dioulasso, Burkina Faso, E-mail: email@example.com. Nicolas Meda, UFR Sciences de la Santé/Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso, E-mail: firstname.lastname@example.org. Hervé Hien, Institut de Recherche en Science de la Santé/CNRST, Ouagadougou; Burkina Faso, E-mail: email@example.com.