# Perceptions and practices in urban Burkina Faso: a qualitative study on gestational age estimation among health workers

## TL;DR

This study explores how healthcare workers in urban Burkina Faso estimate gestational age and identify preterm births, revealing inconsistencies and challenges in their practices.

## Contribution

The study provides new insights into the qualitative practices and perceptions of gestational age estimation among health workers in a low-resource setting.

## Key findings

- Health workers use varying definitions for preterm birth, such as gestational age or birth weight.
- Limited access to early ultrasound leads to reliance on less accurate methods like fundal height measurements.
- Inconsistent documentation and resource shortages hinder effective preterm birth surveillance and care.

## Abstract

The DenBalo study in Burkina Faso aimed to examine biological vulnerability in preterm versus full-term newborns but recorded fewer preterm births than expected based on routine health centre statistics. To investigate this discrepancy, a qualitative study was conducted to understand how healthcare workers assess gestational age in urban Burkina Faso.

Ten in-depth interviews and four focus groups were conducted with health workers across four centres in Bobo-Dioulasso. Thematic analysis revealed five key themes: definitions of preterm birth, gestational age estimation methods, preterm birth reporting, care challenges, and proposed improvements.

Health workers varied in their definitions of preterm birth, using either gestational age (<37 weeks) or birth weight (<2.5 kg). Gestational age is often estimated from the last menstrual period, though considered unreliable. While early ultrasound is preferred for its accuracy, limited access leads to reliance on less precise fundal height measurements. Documentation of preterm births is inconsistent, and challenges include data collection issues, resource shortages, and parental reluctance to seek specialized care. Respondents emphasized the need for greater community awareness, improved infrastructure, and ongoing staff training to enhance preterm care.

Standardized gestational age estimation and improved data recording can enhance preterm birth surveillance and help reduce neonatal mortality in low-resource settings.