An evaluation of healthcare use and child morbidity 4 years after user fee removal in rural Burkina Faso - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Maternal and Child Health Journal Année : 2019

An evaluation of healthcare use and child morbidity 4 years after user fee removal in rural Burkina Faso

D. Zombre
  • Fonction : Auteur
M. de Allegri
  • Fonction : Auteur
R. W. Platt
  • Fonction : Auteur
Valéry Ridde
K. Zinszer
  • Fonction : Auteur

Résumé

Objectives Increasing financial access to healthcare is proposed to being essential for improving child health outcomes, but the available evidence on the relationship between increased access and health remains scarce. Four years after its launch, we evaluated the contextual effect of user fee removal interventionon the probability of an illness occurring and the likelihood of using health services among children under 5. We also explored the potential effect on the inequality in healthcare access. Methods We used a comparative cross-sectional design based upon household survey data collected years after the intervention onset in one intervention and one comparison district. Propensity scores weighting was used to achieve balance on covariates between the two districts, which was followed by logistic multilevel modelling to estimate average marginal effects (AME). Results We estimated that there was not a significant difference in the reduced probability of an illness occurring in the intervention district compared to thenon-intervention district [AME4.4; 95% CI 1.0-9.8)]. However, the probability of using health services was 17.2% (95% CI 15.0-26.6) higher among children living in theintervention district relative to the comparison district, which rose to 20.7% (95% CI 9.9-31.5) for severe illness episodes. We detected no significant differences in the probability of health services use according to socio-economic status [chi(2) (5)=12.90, p=0.61]. Conclusions for Practice In our study, we found that user fee removal led to a significant increase in the use of health services in the longer term, but it is not adequate by itself to reduce the risk of illness occurrence and socioeconomic inequities in the use of health services.

Mots clés

Dates et versions

hal-04097808 , version 1 (15-05-2023)

Identifiants

Citer

D. Zombre, M. de Allegri, R. W. Platt, Valéry Ridde, K. Zinszer. An evaluation of healthcare use and child morbidity 4 years after user fee removal in rural Burkina Faso. Maternal and Child Health Journal, 2019, 23 (6), pp.777-786. ⟨10.1007/s10995-018-02694-0⟩. ⟨hal-04097808⟩
11 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More