User fees removal and community-based management of undernutrition in Burkina Faso: what effects on children’s nutritional status?

2021 ◽  
pp. 1-12
Author(s):  
David Y Zombré ◽  
Manuela De Allegri ◽  
Valéry Ridde ◽  
Kate Zinszer
Keyword(s):  
Burkina Faso ◽  
Household Survey ◽  
Community Level ◽  
User Fees ◽  
Nutrition Status ◽  
Control Group ◽  
Community Based ◽  
Sahel Region ◽  
Intervention District ◽  
Children Under 5

Abstract Objective: To examine the effect of an intervention combining user fees removal with community-based management of undernutrition on the nutrition status in children under 5 years of age in Burkina Faso. Design: The study was a non-equivalent control group post-test-only design based on household survey data collected 4 years after the intervention onset in the intervention and comparison districts. Additionally, we used propensity score weighting to achieve balance on covariates between the two districts, followed by logistic multilevel modelling. Setting: Two health districts in the Sahel region. Participants: Totally, 1116 children under 5 years of age residing in 41 intervention communities and 1305 from 51 control communities. Results: When comparing children living in the intervention district to children living in a non-intervention district, we determined no differences in terms of stunting (OR = 1·13; 95 % CI 0·83, 1·54) and wasting (OR = 1·21; 95 % CI 0·90, 1·64), nor in severely wasted (OR = 1·27; 95 % CI 0·79, 2·04) and severely stunted (OR = 0·99; 95 % CI 0·76, 1·26). However, we determined that 3 % of the variance of wasting (95 % CI 1·25, 10·42) and 9·4 % of the variance of stunting (95 % CI 6·45, 13·38) were due to systematic differences between communities of residence. The presence of the intervention in the communities explained 2 % of the community-level variance of stunting and 3 % of the community-level variance of wasting. Conclusions: With the scaling-up of the national free health policy in Africa, we stress the need for rigorous evaluations and the means to measure expected changes in order to better inform health interventions.

scholarly journals Low coverage but few inclusion errors in Burkina Faso: a community-based targeting approach to exempt the indigent from user fees

2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Valéry Ridde ◽  
Slim Haddad ◽  
Béatrice Nikiema ◽  
Moctar Ouedraogo ◽  
Yamba Kafando ◽  
...  
Keyword(s):  
Burkina Faso ◽  
User Fees ◽  
Community Based ◽  
Low Coverage

Community-Based versus Statistical Targeting of Anti-Poverty Programs: Evidence from Burkina Faso

2019 ◽  
Vol 29 (3) ◽  
pp. 271-305
Author(s):  
Michael Hillebrecht ◽  
Stefan Klonner ◽  
Noraogo A Pacere ◽  
Aurélia Souares
Keyword(s):  
Burkina Faso ◽  
Low Income ◽  
Urban Areas ◽  
Household Survey ◽  
Cost Effective ◽  
Original Data ◽  
Low Income Countries ◽  
Community Based ◽  
Household Level ◽  
Poor Households

Abstract Targeting of governmental welfare programmes in low-income countries commonly relies on statistical procedures involving household-level data, while smaller-scale programmes often employ community-based targeting, where village communities themselves identify beneficiaries. Combining original data from community-based targeting exercises in Burkina Faso with a household survey we compare the targeting accuracy of community-based targeting with four common statistical targeting methods when the objective is to target consumption-poor households. We find that community-based targeting is substantially less accurate than statistical targeting in villages, while it is as accurate as the much more costly statistical methods in semi-urban areas. We show that this difference is due to differences in poverty concepts held by rural and urban communities. Its large cost advantage makes community-based targeting far more cost-effective than statistical targeting for common amounts of welfare programme benefits.

A community-based targeting approach to exempt the worst-off from user fees in Burkina Faso

2009 ◽  
Vol 64 (01) ◽  
pp. 10-15 ◽  
Author(s):  
V Ridde ◽  
M Yaogo ◽  
Y Kafando ◽  
O Sanfo ◽  
N Coulibaly ◽  
...  
Keyword(s):  
Burkina Faso ◽  
User Fees ◽  
Community Based

A spatial analysis of a community-based selection of indigents in Burkina Faso

2013 ◽  
Vol 20 (1_suppl) ◽  
pp. 10-19 ◽  
Author(s):  
Valéry Ridde ◽  
Emmanuel Bonnet ◽  
Aude Nikiema ◽  
Kadidiatou Kadio
Keyword(s):  
Spatial Analysis ◽  
Burkina Faso ◽  
Service User ◽  
Health Centre ◽  
User Fees ◽  
Community Based ◽  
Geographic Accessibility ◽  
Health Centres ◽  
The Village ◽  
Selection Of

Over recent decades, Burkina Faso has improved the geographic accessibility of its health centres. However, patients are still required to pay point-of-service user fees, which excludes the most vulnerable from access to care. In 2010, 259 village committees in the Ouargaye district selected 2649 indigents to be exempted from user fees. The 26 health centre management committees that fund this exemption retained 1097 of those selected indigents. Spatial analysis showed that the management committees retained the indigents who were geographically closer to the health centres, in contrast to the selections of the village committees which were more diversified. Using village committees to select indigents would seem preferable to using management committees. It is not yet known whether the management committees’ selections were due to a desire to maximize the benefits of exemption by giving it to those most likely to use it, or to the fact that they did not personally know the indigents who were more geographically distant from them, or that some villages are not represented at the management committees.

scholarly journals Distance to primary care facilities and healthcare utilization for preschool children in rural northwestern Burkina Faso: results from a surveillance cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Catherine E. Oldenburg ◽  
◽  
Ali Sié ◽  
Mamadou Ouattara ◽  
Mamadou Bountogo ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Healthcare Utilization ◽  
Primary Healthcare ◽  
Healthcare Facility ◽  
Median Number ◽  
Community Level ◽  
Care Seeking ◽  
Healthcare Facilities ◽  
Sick Children ◽  
Children Under 5

Abstract Background Delays in care-seeking for childhood illness may lead to more severe outcomes. We evaluated whether community distance from a primary healthcare facility was associated with decreased healthcare utilization in a rural district of northwestern Burkina Faso. Methods We conducted passive surveillance of all government-run primary healthcare facilities in Nouna District, Burkina Faso from March 1 through May 31, 2020. All healthcare visits for children under 5 years of age were recorded on a standardized form for sick children. We recorded the age, sex, and community of residence of the child as well as any diagnoses and treatments administered. We calculated healthcare utilization per 100 child-months by linking the aggregate number of visits at the community level to the community’s population of children under 5 months per a census that was conducted from August 2019 through February 2020. We calculated the distance between each community and its corresponding healthcare facility and assessed the relationship between distance and the rate of healthcare utilization. Results In 226 study communities, 12,676 primary healthcare visits were recorded over the three-month period. The median distance between the community and primary healthcare facility was 5.0 km (IQR 2.6 to 6.9 km), and median number of healthcare visits per 100 child-months at the community level was 6.7 (IQR 3.7 to 12.3). The rate of primary healthcare visits declined with increasing distance from clinic (Spearman’s rho − 0.42, 95% CI − 0.54 to − 0.31, P < 0.0001). This relationship was similar for cause-specific clinic visits (including pneumonia, malaria, and diarrhea) and for antibiotic prescriptions. Conclusions We documented a distance decay effect between community distance from a primary healthcare facility and the rate of healthcare visits for children under 5. Decreasing distance-related barriers, for example by increasing the number of facilities or targeting outreach to more distant communities, may improve healthcare utilization for young children in similar settings.

scholarly journals Myth and reality of community ownership and control of community-managed piped water systems in Ghana

2020 ◽  
Author(s):  
Nicholas Fielmua
Keyword(s):  
Water Supply ◽  
Household Survey ◽  
Water Systems ◽  
Community Level ◽  
Management Approach ◽  
Community Based ◽  
Services Delivery ◽  
Piped Water ◽  
The Government ◽  
Sustainability Challenges

Abstract Water supply has remained centralised and governments advanced several reasons (health benefits and increase in rural productivity) for the state-led water services delivery. This approach had budgetary and sustainability challenges. This led to a community-based management approach in which communities were required to contribute towards water supply and own the water supply. This paper explores households’ perception of who owns and controls community water systems that were provided under the ambit of community-based management regimes. The study was conducted in four communities in the Upper West Region of Ghana. Data were collected using two main sources: (i) a household survey, using questionnaires; and (ii) a platform, comprising 14 participants. The study found that there is a relationship between community contribution and ownership of the water systems. Community level actors argue that communities own the water systems, because they contributed towards capital cost and are responsible for operations and maintenance. Community level actors have control over the decisions of the water systems. Legal ownership resides in the government and communities manage the water systems and appropriate the returns, thus creating a sense of ownership of the water systems. As such, there is a dualistic ownership of the water systems.

scholarly journals The Effect of Javanese Language Videos with a Community Based Interactive Approach Method as an Educational Instrument for Knowledge, Perception, and Adherence amongst Tuberculosis Patients

Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 86
Author(s):  
Fauna Herawati ◽  
Yuni Megawati ◽  
Aslichah ◽  
Retnosari Andrajati ◽  
Rika Yulia
Keyword(s):  
Intervention Group ◽  
Personal Control ◽  
Control Group ◽  
P Value ◽  
Interactive Approach ◽  
Community Based ◽  
Tuberculosis Patients ◽  
Level Of Knowledge ◽  
The Impact

The long period of tuberculosis treatment causes patients to have a high risk of forgetting or stopping the medication altogether, which increases the risk of oral anti-tuberculosis drug resistance. The patient’s knowledge and perception of the disease affect the patient’s adherence to treatment. This research objective was to determine the impact of educational videos in the local language on the level of knowledge, perception, and adherence of tuberculosis patients in the Regional General Hospital (RSUD) Bangil. This quasi-experimental study design with a one-month follow-up allocated 62 respondents in the intervention group and 60 in the control group. The pre- and post-experiment levels of knowledge and perception were measured with a validated set of questions. Adherence was measured by pill counts. The results showed that the intervention increases the level of knowledge of the intervention group higher than that of the control group (p-value < 0.05) and remained high after one month of follow-up. The perceptions domains that changed after education using Javanese (Ngoko) language videos with the Community Based Interactive Approach (CBIA) method were the timeline, personal control, illness coherence, and emotional representations (p-value < 0.05). More than 95% of respondents in the intervention group take 95% of their pill compared to 58% of respondents in the control group (p-value < 0.05). Utilization of the local languages for design a community-based interactive approach to educate and communicate is important and effective.

scholarly journals Effectiveness of Community Nutrition-Specific Interventions on Improving Malnutrition of Children under 5 Years of Age in the Eastern Mediterranean Region: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (15) ◽  
pp. 7844
Author(s):  
Delaram Ghodsi ◽  
Nasrin Omidvar ◽  
Bahareh Nikooyeh ◽  
Roshanak Roustaee ◽  
Elham Shakibazadeh ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Mediterranean Region ◽  
Eastern Mediterranean ◽  
Meta Analysis ◽  
Eastern Mediterranean Region ◽  
Child Malnutrition ◽  
Z Score ◽  
Community Based ◽  
Nutritional Status Of Children ◽  
Children Under 5

Childhood malnutrition remains an important public health and development problem in low- and middle-income countries. This study aimed to systematically review the community-based nutrition-specific interventions and their effectiveness and/or cost-effectiveness on the nutritional status of children under 5 years of age in the Eastern Mediterranean Region (EMR). A systematic literature search of the English electronic databases, including PubMed, Scopus, ISI Web of Knowledge, Ovid, EMBASE, as well as Persian databases (SID and Magiran) was performed up to May 2019. Studies regarding the effectiveness/cost-effectiveness of the community-based nutrition-specific programs and interventions targeted at under-five-year children in EMR countries were selected. The primary outcomes were mean of Weight-for-age z-score (WAZ), Height-for-Age z-score (HAZ), and Weight-for-Height z-score (WHZ) of children or prevalence of wasting, stunting, and/or underweight among the children. Meta-analysis was also performed on the selected articles and intervention effects (mean differences) were calculated for each outcome for each study and pooled using a weighted random effects model. Risk of bias (ROB) of each included study was assessed based on the Cochrane Handbook for Systematic Reviews. The study protocol was registered in PROSPERO (CRD42020172643). Of 1036 identified studies, eight met the inclusion criteria. Amongst these, seven were from Pakistan and one from Iran. Only one study conducted in Pakistan reported the cost-effectiveness of nutrition-specific interventions in the region. Nutrition education/consultation and cash-based interventions were the most common nutrition-specific strategies used for management of child malnutrition in the EMR countries. Out of these eight studies, four were included in the meta-analysis. When different interventions were pooled, they had resulted in a significant improvement in WHZ of children (MD: 0.26; 95% CI: 0.07 to 0.46, three studies, I2 82.40%). Considering the high prevalence of child malnutrition in a number of countries in the region, capacity building and investigation regarding the implementation of new approaches to improve nutritional status of children and their effect(s) and cost-effectiveness assessment are highly recommended.

scholarly journals Impact and cost-effectiveness evaluation of a community-based rehabilitation intervention on quality of life among Chinese adults with hearing loss: study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xin Ye ◽  
Dawei Zhu ◽  
Siyuan Chen ◽  
Xuefeng Shi ◽  
Rui Gong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hearing Loss ◽  
Cost Effectiveness ◽  
Treatment Group ◽  
Hearing Aids ◽  
Control Group ◽  
Chinese Adults ◽  
Community Based ◽  
The Impact

Abstract Background Hearing loss is quite prevalent and can be related to people’s quality of life. To our knowledge, there are limited studies assessing the efficacy of hearing interventions on quality of life in adults. Therefore, we aim to conduct a randomized controlled trial (RCT) to determine the impact and cost-effectiveness of community-based hearing rehabilitation on quality of life among Chinese adults with hearing loss. Methods/design In this two-arm feasibility study, participants aged 16 and above with some degree of hearing loss (n = 464) will be recruited from Linyi City, Shandong Province. They are randomly assigned to the treatment group or the control group. Those in the treatment group are prescribed with hearing aids, while those in the control group receive no intervention. Reinstruction in use of devices is provided for the treatment group during booster visits held 12 months post-randomization or unscheduled interim visits when necessary. Data are collected at baseline and the follow-up 20 months later. The primary outcome is changes in quality of life over a 20-month study period. Secondary outcomes include sub-dimensions in quality of life, physical functioning, chronic diseases, cognitive function, depression, social support, hospitalizations, falls, and healthcare costs. Finally, we will evaluate whether hearing aids intervention is cost-effective to apply in a large scale. Discussion The trial is designed to evaluate the impact and cost-effectiveness of a community-based rehabilitation intervention on quality of life among Chinese adults with hearing loss. We hope that it would help improve the well-being for Chinese adults and provide references in policy and practice for China and other countries. Trial registration Chinese Clinical Trial Registry ChiCTR1900024739. Registered on 26 July 2019.

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