In Burkina Faso, the DenBalo study aimed to explore differences in vulnerability between preterm and full-term newborns but found fewer preterm cases than anticipated based on routine health centre records. This follow-up study investigates how urban healthcare workers determine gestational age and the factors influencing their assessments. Researchers conducted ten individual interviews and four focus groups with healthcare staff across four facilities in Bobo-Dioulasso. Thematic analysis focused on practices for defining and measuring preterm birth, recording methods, care challenges, and suggested improvements. Definitions of preterm birth varied: some staff relied on gestational age under 37 weeks, while others used birth weight below 2.5 kg. Estimations often depended on the last menstrual period, though its reliability was questioned. Early ultrasound was preferred for precision, but limited access meant fundal height measurements were commonly used. Reporting practices were inconsistent, and healthcare workers faced obstacles including insufficient resources, difficulties in accurate data collection, and parental reluctance to seek specialized care. Staff highlighted the importance of community education, enhanced health infrastructure, and continuous professional training to improve outcomes. Accurate and consistent gestational age assessment, paired with better documentation, is essential for tracking preterm births and supporting neonatal care in resource-limited urban settings.
