scholarly journals Does the implementation of UHC reforms foster greater equality in health spending? Evidence from a benefit incidence analysis in Burkina Faso

2021 ◽  
Vol 6 (12) ◽  
pp. e005810
Author(s):  
Manuela De Allegri ◽  
Martin Rudasingwa ◽  
Edmund Yeboah ◽  
Emmanuel Bonnet ◽  
Paul André Somé ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Public Spending ◽  
Health Spending ◽  
Household Survey ◽  
Sub Saharan Africa ◽  
Health Coverage ◽  
Delivery Services ◽  
Distributional Incidence ◽  
Sub Saharan ◽  
Health Accounts

IntroductionBurkina Faso is one among many countries in sub-Saharan Africa having invested in Universal Health Coverage (UHC) policies, with a number of studies have evaluated their impacts and equity impacts. Still, no evidence exists on how the distributional incidence of health spending has changed in relation to their implementation. Our study assesses changes in the distributional incidence of public and overall health spending in Burkina Faso in relation to the implementation of UHC policies.MethodsWe combined National Health Accounts data and household survey data to conduct a series of Benefit Incidence Analyses. We captured the distribution of public and overall health spending at three time points. We conducted separate analyses for maternal and curative services and estimated the distribution of health spending separately for different care levels.ResultsInequalities in the distribution of both public and overall spending decreased significantly over time, following the implementation of UHC policies. Pooling data on curative services across all care levels, the concentration index (CI) for public spending decreased from 0.119 (SE 0.013) in 2009 to −0.024 (SE 0.014) in 2017, while the CI for overall spending decreased from 0.222 (SE 0.032) in 2009 to 0.105 (SE 0.025) in 2017. Pooling data on institutional deliveries across all care levels, the CI for public spending decreased from 0.199 (SE 0.029) in 2003 to 0.013 (SE 0.002) in 2017, while the CI for overall spending decreased from 0.242 (SE 0.032) in 2003 to 0.062 (SE 0.016) in 2017. Persistent inequalities were greater at higher care levels for both curative and institutional delivery services.ConclusionOur findings suggest that the implementation of UHC in Burkina Faso has favoured a more equitable distribution of health spending. Nonetheless, additional action is urgently needed to overcome remaining barriers to access, especially among the very poor, further enhancing equality.

scholarly journals Characterisation of the rural indigent population in Burkina Faso: a screening tool for setting priority healthcare services in sub-Saharan Africa

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e013405 ◽  
Author(s):  
Samiratou Ouédraogo ◽  
Valéry Ridde ◽  
Nicole Atchessi ◽  
Aurélia Souares ◽  
Jean-Louis Koulidiati ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Classification Tree ◽  
Healthcare Services ◽  
Married Women ◽  
Sub Saharan Africa ◽  
Free Access ◽  
Health Coverage ◽  
Sub Saharan ◽  
Government Ethics ◽  
And Gender

BackgroundIn Africa, health research on indigent people has focused on how to target them for services, but little research has been conducted to identify the social groups that compose indigence. Our aim was to identify what makes someone indigent beyond being recognised by the community as needing a card for free healthcare.MethodsWe used data from a survey conducted to evaluate a state-led intervention for performance-based financing of health services in two districts of Burkina Faso. In 2015, we analysed data of 1783 non-indigents and 829 people defined as indigents by their community in 21 villages following community-based targeting processes. Using a classification tree, we built a model to select socioeconomic and health characteristics that were likely to distinguish between non-indigents and indigents. We described the screening performance of the tree using data from specific nodes.ResultsWidow(er)s under 45 years of age, unmarried people aged 45 years and over, and married women aged 60 years and over were more likely to be identified as indigents by their community. Simple rules based on age, marital status and gender detected indigents with sensitivity of 75.6% and specificity of 55% among those 45 years and over; among those under 45, sensitivity was 85.5% and specificity 92.2%. For both tests combined, sensitivity was 78% and specificity 81%.ConclusionIn moving towards universal health coverage, Burkina Faso should extend free access to priority healthcare services to widow(er)s under 45, unmarried people aged 45 years and over, and married women aged 60 years and over, and services should be adapted to their health needs.Ethics considerationsThe collection, storage and release of data for research purposes were authorised by a government ethics committee in Burkina Faso (Decision No. 2013-7-066). Respondent consent was obtained verbally.

scholarly journals Contraceptive dynamics during COVID-19 in sub-Saharan Africa: longitudinal evidence from Burkina Faso and Kenya

2021 ◽  
pp. bmjsrh-2020-200944
Author(s):  
Celia Karp ◽  
Shannon N Wood ◽  
Georges Guiella ◽  
Peter Gichangi ◽  
Suzanne O Bell ◽  
...  
Keyword(s):  
At Risk ◽  
Burkina Faso ◽  
Unintended Pregnancy ◽  
Sexual And Reproductive Health ◽  
Universal Access ◽  
Sociodemographic Factors ◽  
Sub Saharan Africa ◽  
Contraceptive Services ◽  
Logistic Regressions ◽  
Sub Saharan

IntroductionEvidence from health emergencies suggests COVID-19 will disrupt women’s sexual and reproductive health (SRH). In sub-Saharan Africa, which experiences the highest rates of unintended pregnancy and unsafe abortion globally, COVID-19 is projected to slow recent progress toward universal access to contraceptive services.MethodsWe used longitudinal data collected from women at risk of unintended pregnancy in Burkina Faso (n=1186) and Kenya (n=2784) before (November 2019–February 2020) and during (May–July 2020) COVID-19 to quantify contraceptive dynamics during COVID-19; examine sociodemographic factors and COVID-19 experiences related to contraceptive dynamics; and assess COVID-19-related reasons for contraceptive non-use. Bivariate and multivariate logistic regressions were used to examine correlates of contraceptive dynamics amid COVID-19.ResultsMost women did not change their contraceptive status during COVID-19 (68.6% in Burkina Faso and 81.6% in Kenya) and those who did were more likely to adopt a method (25.4% and 13.1%, respectively) than to discontinue (6.0% and 5.3%, respectively). Most women who switched contraceptives were using methods as or more effective than their pre-pandemic contraception. Economic instability related to COVID-19 was associated with increased contraceptive protection in Burkina Faso but not in Kenya. Altogether, 14.4% of non-contraceptive users in Kenya and 3.8% in Burkina Faso identified COVID-19-related reasons for non-use.ConclusionsThe vast majority of women at risk of unintended pregnancy did not change their contraceptive status during COVID-19, and more women adopted than discontinued methods. A minority of women reported COVID-19-related reasons for non-use, underscoring the importance of expanding safe modes of service delivery during health crises.

scholarly journals The COVID-19 Pandemic and Non-communicable Diseases—A Wake-up Call for Primary Health Care System Strengthening in Sub-Saharan Africa

2020 ◽  
Vol 11 ◽  
pp. 215013272094694
Author(s):  
Christian Kraef ◽  
Pamela Juma ◽  
Per Kallestrup ◽  
Joseph Mucumbitsi ◽  
Kaushik Ramaiya ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Systems ◽  
Health Spending ◽  
Communicable Diseases ◽  
Sub Saharan Africa ◽  
Primary Health Care System ◽  
Health Coverage ◽  
Non Communicable Diseases ◽  
Primary Health

Strengthening Primary Health Care Systems is the most effective policy response in low-and middle-income countries to protect against health emergencies, achieve universal health coverage, and promote health and wellbeing. Despite the Astana declaration on primary health care, respective investment is still insufficient in Sub-Sahara Africa. The SARS-CoV-2019 pandemic is a reminder that non-communicable diseases (NCDs), which are increasingly prevalent in Sub-Sahara Africa, are closely interlinked to the burden of communicable diseases, exacerbating morbidity and mortality. Governments and donors should use the momentum created by the pandemic in a sustainable and effective way by pivoting health spending towards primary health care.

OP109 The Need For Building Pharmacists’ Health Technology Assessment Capacity; The Nigerian Scenario

2019 ◽  
Vol 35 (S1) ◽  
pp. 26-26
Author(s):  
Otuto Amarauche Chukwu ◽  
Chizaram Chukwu
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Health Coverage ◽  
Healthcare Decision ◽  
Healthcare Decision Making ◽  
Sub Saharan

IntroductionThe role of Health technology assessment (HTA) as a systematic approach in the evaluation of health interventions and technologies is becoming increasingly important as the quest for attaining universal health coverage globally continues to increase. Some developed countries in Europe and the Americas now apply HTA extensively in healthcare policy decisions, however, developing regions and countries like sub-Saharan Africa and Nigeria respectively, seem not to be making significant progress in this area. Given that evidence suggests that Nigeria and indeed several countries in sub-Saharan Africa are performing poorly on most healthcare indices as the region continues to be ravaged by predictable and avoidable epidemics and disease outbreaks, the need to build HTA capacity has never been more paramount.MethodsA review of HTA capability in Nigeria was done. Pharmacists in Nigeria's Capital were randomly sampled. Semi-structured questionnaires were administered. Descriptive statistics were used in data analysis. P values less than 0.05 were considered to be significant.ResultsIn Nigeria, there is no institution tasked with undertaking HTA and there seems to be limited knowledge, capacity and awareness on the issue. Pharmacists, being the most accessible healthcare professionals according to evidence, are a key group that could play an active role in HTA and its implementation in developing countries like Nigeria. However, out of 322 pharmacists randomly sampled, 93 percent were not aware of HTA and its application in healthcare decision-making.ConclusionsThere is no paucity of healthcare programs and plans in Nigeria but they seem to fail due to lack of evidence-based assessment, decision-making and implementation. Hence, there is an increasing need to raise awareness on the importance of HTA in healthcare decision-making; strengthen HTA capacity by developing and sustaining institutional capacity and adequate human resource for HTA; and creating regional annexes of HTA organizations in Africa.

scholarly journals Disability and Household Welfare in Ghana: Costs and Correlates

2020 ◽  
Author(s):  
Derek Asuman ◽  
Charles Godfred Ackah ◽  
Frank Agyire-Tettey
Keyword(s):  
Social Services ◽  
Household Survey ◽  
Extra Cost ◽  
Sub Saharan Africa ◽  
Economic Activities ◽  
Persons With Disabilities ◽  
Vulnerability To Poverty ◽  
Nationally Representative ◽  
Sub Saharan ◽  
Using Data

AbstractPersons with disabilities face substantial barriers that impede their integration and participation in social and economic activities. Households with disabled members may be vulnerable to poverty due to the extra cost of living with a disability. However, there exists a knowledge gap in the magnitude of the extra cost of disabilities in sub Saharan Africa. Using data from a nationally representative household survey, this paper estimates the extra cost of disabilities in Ghana. The paper further examines the welfare effects of households with persons with disabilities. Based on the standard of living approach, we estimate the extra cost to households with a person with disability to be 26% of annual household consumption expenditures. Adjusting for the extra cost of poverty, the incidence of poverty increases from 38.5 to 52.9% amongst households with a disabled member. Our findings suggest the need to improve the efficiency of support programs to persons with disabilities to mitigate the extra costs of disabilities and reduce their vulnerability to poverty. In addition, enhancing access to economic opportunities and social services for persons with disabilities will be imperative to improve their quality of life and dignity.

scholarly journals ‘Grandmother, aren’t you going to sing for us?’ Current childcare practices and caregivers’ perceptions of and receptivity to early childhood development activities in rural Burkina Faso

2019 ◽  
Vol 4 (2) ◽  
pp. e001233 ◽  
Author(s):  
Jennifer Hollowell ◽  
Mari Dumbaugh ◽  
Mireille Belem ◽  
Sylvain Kousse ◽  
Tessa Swigart ◽  
...  
Keyword(s):  
Early Childhood ◽  
Young Children ◽  
Burkina Faso ◽  
Early Childhood Development ◽  
Sub Saharan Africa ◽  
Childhood Development ◽  
Media Intervention ◽  
Sub Saharan ◽  
Children's Development ◽  
Children’S Development

IntroductionEffective stimulation and responsive caregiving during the first 2 years is crucial for children’s development. By age 3–4 years, over 40% of children in sub-Saharan Africa fail to meet basic cognitive or socioemotional milestones, but there are limited data on parenting and childcare practices. This study, conducted to inform the design of a mass media intervention, explored practices, perceptions, motivators and obstacles to childhood development-related practices among parents and caregivers of children aged 0–2 years in rural Burkina Faso.MethodsWe performed two rounds of six focus groups with 41 informants in two villages, using an adapted version of the Trials of Improved Practices methodology. These first explored beliefs and practices, then introduced participants to the principles and benefits of early childhood development (ECD) and provided illustrative examples of three practices (interactive ways of talking, playing and praising) to try with their children. One week later, further discussions explored participants’ experiences and reactions. Data were analysed inductively using thematic content analysis.ResultsExisting activities with young children were predominantly instructive with limited responsive interaction and stimulation. Participants were receptive to the practices introduced, noted positive changes in their children when they adopted these practices and found engagement with children personally rewarding.ConclusionInteractive, stimulating activities with young children did not appear to be widespread in the study area, but caregivers were receptive to information about the importance of early stimulation for children’s development. ECD messages should be tailored to the local sociocultural context and consider time limitations.

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