Targeting the worst-off for free health care : a process evaluation in Burkina Faso
Date
2011
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
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.
Description
item.page.type
Journal Article (peer-reviewed)
item.page.format
Text
Keywords
EXEMPTION, WORST-OFF, TARGETING, PROCESS EVALUATION, BURKINA FASO, FREE HEALTH CARE, USER CHARGES, COMMUNITY PARTICIPATION, POVERTY, RIGHT TO HEALTH, HEALTH SERVICES, HEALTHCARE COSTS
Citation
Ridde, V., Yaogo, M., Kafando, Y., Kadio, K., Ouedraogo, M., Bicaba, A., & Haddad, S. (2011). Targeting the worst-off for free health care: A process evaluation in Burkina Faso. Evaluation and Program Planning, 34, 333-342.doi:10.1016/j.evalprogplan.2011.03.007