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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
business, management and accounting
Targeting the worst-off for free health care: A process evaluation in Burkina Faso
Evaluation and Program Planning, Volume 34, No. 4, Year 2011
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Description
Effective mechanisms to exempt the indigent from user fees at health care facilities are rare in Africa. A State-led intervention (2004-2005) and two action research projects (2007-2010) were implemented in a health district in Burkina Faso to exempt the indigent from user fees. This article presents the results of the process evaluation of these three interventions.Individual and group interviews were organized with the key stakeholders (health staff, community members) to document the strengths and weaknesses of key components of the interventions (relevance and uptake of the intervention, worst-off selection and information, financial arrangements). Data was subjected to content analysis and thematic analysis.The results show that all three intervention processes can be improved. Community-based targeting was better accepted by the stakeholders than was the State-led intervention. The strengths of the community-based approach were in clearly defining the selection criteria, informing the waiver beneficiaries, using a participative process and using endogenous funding. A weakness was that using endogenous funding led to restrictive selection by the community.The community-based approach appears to be the most effective, but it needs to be improved and retested to generate more knowledge before scaling up. © 2011 Elsevier Ltd.
Authors & Co-Authors
Ridde, Valéry
Canada, Montreal
Centre Hospitalier de L'universite de Montreal
Canada, Montreal
University of Montreal
Burkina Faso
Institut de Recherche en Sciences de la Santé Irss du Cnrst
Yaogo, Maurice
Burkina Faso, Bobo-dioulasso
Université Catholique de L'afrique de L'ouest
Kafando, Yamba
Burkina Faso
Société D'étude et de Recherche en Santé Publique Sersap
Kadio, Kadidiatou
Burkina Faso
Société D'étude et de Recherche en Santé Publique Sersap
Ouédraogo, Moctar
Unknown Affiliation
Bicaba, Abel
Burkina Faso
Société D'étude et de Recherche en Santé Publique Sersap
Haddad, Slim
Canada, Montreal
Centre Hospitalier de L'universite de Montreal
Canada, Montreal
University of Montreal
Statistics
Citations: 27
Authors: 7
Affiliations: 6
Identifiers
Doi:
10.1016/j.evalprogplan.2011.03.007
ISSN:
01497189
Study Design
Randomised Control Trial
Study Approach
Qualitative
Study Locations
Burkina Faso