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Article Dans Une Revue Value in Health Année : 2020

Economic evaluation of user-fee exemption policies for maternal healthcare in Burkina Faso : evidence from a cost-effectiveness analysis

H. T. Nguyen
  • Fonction : Auteur
A. Torbica
  • Fonction : Auteur
S. Brenner
  • Fonction : Auteur
J. A. Kiendrebeogo
  • Fonction : Auteur
L. Tapsoba
  • Fonction : Auteur
Valéry Ridde
M. de Allegri
  • Fonction : Auteur

Résumé

Objectives: The reduction and removal of user fees for essential care services have recently become a key instrument to advance universal health coverage in sub-Saharan Africa, but no evidence exists on its cost-effectiveness. We aimed to address this gap by estimating the cost-effectiveness of 2 user-fee exemption inte rventions in Burkina Faso between 2007 and 2015: the national 80% user-fee reduction policy for delivery care services and the user-fee removal pilot (ie, the complete [100%] user-fee removal for delivery care) in the Sahel region. Methods: We built a single decision tree to evaluate the cost-effectiveness of the 2 study interventions and the baseline. The decision tree was populated with an own impact evaluation and the best available epidemiological evidence. Results: Relative to the baseline, both the national 80% user-fee reduction policy and the user-fee removal pilot are highly cost-effective, with incremental cost-effectiveness ratios of $210.22 and $252.51 per disability-adjusted life-year averted, respectively. Relative to the national 80% user-fee reduction policy, the user-fee removal pilot entails an incremental cost-effectiveness ratio of $309.74 per disability-adjusted life-year averted. Conclusions: Our study suggests that it is worthwhile for Burkina Faso to move from an 80% reduction to the complete removal of user fees for delivery care. Local analyses should be done to identify whether it is worthwhile to implement user-fee exemptions in other sub-Saharan African countries.

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Dates et versions

hal-04095695 , version 1 (12-05-2023)

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Citer

H. T. Nguyen, A. Torbica, S. Brenner, J. A. Kiendrebeogo, L. Tapsoba, et al.. Economic evaluation of user-fee exemption policies for maternal healthcare in Burkina Faso : evidence from a cost-effectiveness analysis. Value in Health, 2020, 23 (3), pp.300-308. ⟨10.1016/j.jval.2019.10.007⟩. ⟨hal-04095695⟩
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