Les modalités de collecte du financement de la santé au Burkina Faso de 1980 à 2012

Abstract

As a step towards universal health coverage, African countries need to develop funding systems that are effective, equitable, and tailored to national circumstances. To support policy makers in Burkina Faso, we present a review of research on interventions related to user fees, prepayment plans, and user fee subsidies. We compiled a narrative summary of articles published in scientific journals between 1980 and 2012. In all, 64 articles were selected. A thematic analysis was performed. User fees are a barrier to access to care; they curtail the use of health services and exclude the worst-off. People prefer prepayment plans in which each household pays an annual premium. However, the insurance premium remains a barrier to membership. Insurance does not benefit the poor but increases the use of health services by the insured. The subsidy for facility-based deliveries was not sufficiently well planned and difficulties have been observed in its implementation. While it helps reduce costs and improves access to care, it has not reduced inequalities. Community-based and participatory interventions have been useful for identifying the worst-off in order to exempt them from user fees. While prepayment is being promoted internationally as a financing model for universal health coverage, the evidence in favour of this system in Burkina Faso is still very limited. Further studies, more representative of the national context, must be conducted on this option, while at the same time, continuing efforts must be made to identify solutions for the poor who are unable to pay.

Presence of three dengue serotypes in Ouagadougou (Burkina Faso): research and public health implications

“…Even though this study’s findings regarding health expenses and services use are limited because of our small sample, they nevertheless highlight, once more, the challenges of healthcare accessibility and the financial burden these can generate [ 49 ]. There have been numerous studies in Burkina Faso on these issues [ 50 ], but again, none have looked specifically at dengue. Such studies have yet to be conducted in Africa [ 49 ], with particular attention on equity issues.…”

“…In Cambodia, for example, studies have revealed the extent to which families become indebted to cover expenses related to dengue episodes [ 51 ], and the overall financial burden for society and its economy is enormous [ 52 ]. The fact that Burkina Faso’s health system is still based on user fees means there is an important financial barrier to healthcare access [ 50 ]. New dengue epidemics could exacerbate these impacts for families, especially for the poorest, as was clearly demonstrated in Cambodia [ 53 ].…”

A study on the implementation fidelity of the performance-based financing policy in Burkina Faso after 12 months

“…Thus, the aim of the present study was to deepen our understanding of the “black box” of PBF, taking Burkina Faso as a case study. In Burkina Faso, the achievement of UHC continues to be compromised by insufficient health funding and poor health system performance [ 21 ], with child and maternal mortality rates among the highest globally [ 22 ]. The situation prompted the Ministry of Health (MOH) to undertake a PBF intervention through a World Bank(WB)-supported project, as a trial project in three districts first in 2011 and since 2014 under the form of a three-year pilot project.…”

Une politique concernant les données issues d’un programme de recherches interventionnelles en santé mondiale

“…Le fait que la plupart des premiers auteurs des articles tirés de ces partenariats soient situés dans des institutions du Nord est source de débat [28]. Notre analyse des articles parus depuis 30 ans concernant le financement de la santé au Burkina Faso montre que les chercheurs du pays ne sont premiers auteurs que dans 5% des articles auxquels ils participent [29]. Cette question devient importante puisque la collaboration scientifique internationale est en croissance.…”