National user fee abolition and health insurance scheme in Burkina Faso: How can they be integrated on the road to universal health coverage without increasing health inequities?

Bicaba, Frank; Browne, Lalique; Kadio, Kadidiatou; Bila, Alice; Bicaba, Abel; Druetz, Thomas

doi:10.7189/jogh.10.010319

Cited by 15 publications

(19 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The free healthcare policy has been implemented in all public health facilities, this could explain the increase in the use of public facilities and the decrease in the use of private facilities. 22 This study suggests that free healthcare is not the only measure necessary to increase the prevalence of children seeking care for a fever. Besides financial barriers, there is a whole series of non-financial barriers that play a role in care-seeking-wealth index, regions, having heard or seen messages about malaria, and the age of the child were all associated with not seeking care for a fever in children under the age of five.…”

Section: Discussionmentioning

confidence: 88%

“…Based on a literature review, we identified the following independent variables that were relevant to household, mother/caregivers, and child characteristics that could influence care-seeking: [19][20][21][22][23][24] -Child characteristics: gender of the child (male or female); the age of the child in months (<12 months, 12-35 months, or 36-59 months); the place where care was first sought (public, private, or traditional/other).…”

Section: Independent Variablesmentioning

confidence: 99%

See 1 more Smart Citation

Care-Seeking for Fever for Children Under the Age of Five Before and After the Free Healthcare Initiative in Burkina Faso: Evidence from Three Population-Based Surveys

Negatou¹,

Ouédraogo²,

Donnen³

et al. 2021

RMHP

View full text Add to dashboard Cite

Background: In 2016, a free healthcare policy (FHP) was implemented in Burkina Faso for children under the age of five. In our study, we aimed to determine the prevalence of careseeking for a fever in children under the age of five before and after the implementation of the FHP and to analyze the determinants of not seeking care under the FHP. Methods: The data of three nationally representative surveys were used to evaluate the trends of the prevalence of care-seeking. We performed a modified Poisson regression using a generalized estimating equation to determine the factors associated with not seeking care. Results: The prevalence for care seeking increased from 57.5% (95% CI, 54.2-60.8) in 2014 to 72.3% (95% CI, 68.1-76.2) in 2017. Children from the poor quintile were less likely to seek care when compared to children from the poorest quintile (prevalence ratio (PR) = 0.7 (95% CI, 0.5-0.9)). Caregivers who did not have messages regarding malaria in the past six months were more likely not to seek care (PR = 0.8 (95% CI, 0.7-0.9)). Caregivers of children aged 36-59 months were more likely not to seek care compared to those aged <12 months (PR = 1.6 (95% CI, 1.2-2.1)). Children from the Boucle du Mouhoun region (PR = 1.9 (95% CI, 1.2-3.2)) and the Centre-Est region (PR = 1.9 (95% CI, 1.2-3.0)) were more likely not to seek care compared to children from the Sud Ouest region. Conclusion: Our study showed an increase in the prevalence of care-seeking after the implementation of the FHP. Even if this is encouraging, these findings highlight the critical importance of non-financial barriers to care-seeking. Maintaining FHP and tackling the barriers should be considered by policy makers to increase care-seeking.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Independent Variablesmentioning

confidence: 99%

Care-Seeking for Fever for Children Under the Age of Five Before and After the Free Healthcare Initiative in Burkina Faso: Evidence from Three Population-Based Surveys

Negatou¹,

Ouédraogo²,

Donnen³

et al. 2021

RMHP

View full text Add to dashboard Cite

show abstract

“…Burkina Faso has implemented several measures over the past 10 years to increase its population's access to healthcare services. 21 It has been one of the first countries in sub-Saharan Africa to remove healthcare user fees for children under 5 years of age and for pregnant women. 45 However, rising insecurity since 2015, mainly caused by terrorist attacks, is a major challenge to the achievement of universal health coverage.…”

Section: Discussionmentioning

confidence: 99%

“…20 In order to improve coverage, the Government of Burkina Faso has gradually mitigated the cost of healthcare services, first in 2007 by reducing fees associated to assisted deliveries by 80%, then in 2016 by abolishing all user fees for maternal healthcare services. 21 Studies have demonstrated the positive impact of these initiatives on many indicators of maternal health, including the volume of antenatal care (ANC) visits and assisted deliveries, as well as on health inequalities. 22 23 However, as suggested by a recent study, the improvements in access to healthcare are fragile in Burkina Faso, and are likely to disappear rapidly if a new barrier is introduced, or if a former barrier is reinstituted.…”

Section: What Do the New Findings Imply?mentioning

confidence: 99%

Effects of terrorist attacks on access to maternal healthcare services: a national longitudinal study in Burkina Faso

et al. 2020

Self Cite

View full text Add to dashboard Cite

IntroductionMost of the literature on terrorist attacks’ health impacts has focused on direct victims rather than on distal consequences in the overall population. There is limited knowledge on how terrorist attacks can be detrimental to access to healthcare services. The objective of this study is to assess the impact of terrorist attacks on the utilisation of maternal healthcare services by examining the case of Burkina Faso.MethodsThis longitudinal quasi-experimental study uses multiple interrupted time series analysis. Utilisation of healthcare services data was extracted from the National Health Information System in Burkina Faso. Data span the period of January 2013–December 2018 and include all public primary healthcare centres and district hospitals. Terrorist attack data were extracted from the Armed Conflict Location and Event Data project. Negative binomial regression models were fitted with fixed effects to isolate the immediate and long-term effects of terrorist attacks on three outcomes (antenatal care visits, of facility deliveries and of cesarean sections).ResultsDuring the next month of an attack, the incidence of assisted deliveries in healthcare facilities is significantly reduced by 3.8% (95% CI 1.3 to 6.3). Multiple attacks have immediate effects more pronounced than single attacks. Longitudinal analysis show that the incremental number of terrorist attacks is associated with a decrease of the three outcomes. For every additional attack in a commune, the incidence of cesarean sections is reduced by 7.7% (95% CI 4.7 to 10.7) while, for assisted deliveries, it is reduced by 2.5% (95% CI 1.9 to 3.1) and, for antenatal care visits, by 1.8% (95% CI 1.2 to 2.5).ConclusionTerrorist attacks constitute a new barrier to access of maternal healthcare in Burkina Faso. The exponential increase in terrorist activities in West Africa is expected to have negative effects on maternal health in the entire region.

show abstract

“…L'abolition du paiement direct améliorerait aussi certains indicateurs de morbidité et réduirait la mortalité néonatale (23)(24)(25). Les études de mise en oeuvre ont, quant à elles, révélé un large soutien des communautés et du personnel soignant, en plus de déboulonner certains mythes à l'égard de la faisabilité ; cependant, elles ont aussi mis en lumière des difficultés concernant la qualité des soins, leur valorisation, le renforcement du système de santé, sans oublier l'enjeu fondamental de la pérennité des initiatives de gratuité (26)(27)(28)(29)(30)(31). Enfin, les politiques de gratuité ne répondent qu'en partie aux problèmes de l'accès aux soins, puisqu'elles atténuent la barrière financière, mais n'agissent pas sur la barrière géographique ou socio-culturelle.…”

Section: Introductionunclassified

Soins de santé gratuits pour les uns, payants pour les autres : perceptions et stratégies d’adaptation dans le district de Boulsa (Burkina Faso)

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

National user fee abolition and health insurance scheme in Burkina Faso: How can they be integrated on the road to universal health coverage without increasing health inequities?

Cited by 15 publications

References 8 publications

Care-Seeking for Fever for Children Under the Age of Five Before and After the Free Healthcare Initiative in Burkina Faso: Evidence from Three Population-Based Surveys

Care-Seeking for Fever for Children Under the Age of Five Before and After the Free Healthcare Initiative in Burkina Faso: Evidence from Three Population-Based Surveys

Effects of terrorist attacks on access to maternal healthcare services: a national longitudinal study in Burkina Faso

Soins de santé gratuits pour les uns, payants pour les autres : perceptions et stratégies d’adaptation dans le district de Boulsa (Burkina Faso)

Contact Info

Product

Resources

About