1. Community-led planning to improve maternal and newborn health in Tenkodogo district, Burkina Faso Perkins, Janet a, Capello Cecilia a, Sankara, Tougma Téné a, Portela, Annie b and Santarelli, Carlo a a Enfants du Monde; b World Health Organization, Department of Maternal, Newborn, Child and Adolescent health Institutional Forum (Representatives from each round table discussion; development partners; political, cultural, religious, administrative authorities) Women of reproductive age Husbands/ partners Community Leaders Health care providers Influential family members Women find it difficult to reduce their heavy workload during pregnancy Women are not aware of healthy diet and hygiene practices during pregnancy Developing CAPACITIES to stay healthy, make healthy decisions, and respond to obstetric and neonatal emergencies The community is not aware of the causes of maternal and newborn death Women delay seeking health services due to low decision-making ability, preference for traditional medicine, lack of planning etc. Increasing AWARENESS of the rights, needs and potential problems related to maternal and newborn health Women find it difficult to reach maternal and newborn health services as a result of physical barriers, including lack of infrastructure, transportation and financial means Strengthening LINKAGES for social support between women, men, families and communities and with the health delivery system Women are not satisfied with their reception at health facilities or their interactions with health care providers There is a lack of quality health services available in health facilities Improving QUALITY of care, health services and interactions with women and communities Intervention site: Tenkodogo district Population: 189 778 Background: Burkina Faso: -Maternal mortality ratio: 560/100 000 (WHO 2008) -Newborn Mortality Rate: 38/1 000 (UNICEF 2010) Intervention Area (Annuaire Statistique 2009): -65.3% births with a skilled birth attendant -20.9% antenatal care coverage (4 visits) Partners: Burkina Faso Ministry of Health, Enfants du Monde, UNFPA Year of intervention: 2008 Conclusion: By giving precedence to underrepresented voices, the participatory community assessment identified priority concerns related to maternal and newborn health and barriers to healthcare access that were not revealed through situation analyses using extant data. Moreover, their ideas and solutions are integrated with those of local decision makers and health providers, further increasing their voice and the potential for programme success. Organization of participatory community assessment Results of the participatory community assessment Background: Burkina Faso Ministry of Health, supported by Enfants du Monde and UNFPA, is currently implementing a nationwide programme based on the WHO framework for working with Individuals, Families and Communities (IFC) to improve maternal and newborn health. Fundamental to this framework is community participation throughout all programme phases, starting with planning. The rationale guiding planning is that consulting community members is essential to identify priority needs and potential solutions as well as to empower the community. Based on this principle, a participatory community assessment was conducted in Tenkodogo district. Methods: Thirty-five representatives from the Ministries of Health, Education and Social Affaires were selected and trained by Enfants du Monde to conduct the participatory community assessment. The assessment consisted of five 2-day round table discussions and an institutional forum. Each round table discussion was composed of 30 participants (for a total of 150 participants) falling into the following categories:  pregnant women/women with children under the age of one  husbands of pregnant women/women with children under the age of one  influential family members of women during pregnancy (mothers, mothers-in-law, sisters, sisters-in-law)  community leaders  health care providers. Participants discussed the health of pregnant women, mothers and newborns in the community and identified key factors preventing them from making healthy choices during pregnancy and receiving the care they need. Participants then explored existing community resources and possible solutions to resolving identified problems. Following the round table discussions, an institutional forum conducted over two days was held during which participants examined the results of each round table discussion, prioritised maternal and newborn health needs and developed solutions to respond to the needs. Tenkodogo district, Centre-Est Region