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Low utilization of community health workers: Results from a household interview survey in Burkina Faso

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  • Sauerborn, R.
  • Nougtara, A.
  • Diesfeld, H. J.

Abstract

A representative household survey was carried out in order to study the utilization of community health workers (CHW) in relation to other sources of health care. We found three main results: (1) For mild diseases, villagers consulted their CHW only in 8.8% of mild diseases, in 69% the family remained the main provider of primary care. (2) In the case of serious diseases, which the CHW was supposed to identify and refer, the villagers bypassed the CHW in 96.5%. The professional health worker were consulted directly in the majority of serious disease. (3) Sick infants were not taken to the CHW for treatment. (4) No pattern of referral between professional and CHWs could be traced. Severity of disease and perceived effectiveness of the treatment were the most important determinants of health seeking behavior. Availability, distance, and cost of travel and drugs were important service related determinants. Individual and household characteristics such as income, ethnicity, and household size were only weakly associated with choice of curative care. Reasons for the low utilization of CHWs are outlined and policy implications discussed.

Suggested Citation

  • Sauerborn, R. & Nougtara, A. & Diesfeld, H. J., 1989. "Low utilization of community health workers: Results from a household interview survey in Burkina Faso," Social Science & Medicine, Elsevier, vol. 29(10), pages 1163-1174, January.
    • Handle: RePEc:eee:socmed:v:29:y:1989:i:10:p:1163-1174
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    Cited by:

    1. Dong, Hengjin & Kouyate, Bocar & Cairns, John & Sauerborn, Rainer, 2005. "Inequality in willingness-to-pay for community-based health insurance," Health Policy, Elsevier, vol. 72(2), pages 149-156, May.
    2. Leonard, Kenneth L, 2007. "Learning in Health Care: Evidence of Learning about Clinician Quality in Tanzania," Economic Development and Cultural Change, University of Chicago Press, vol. 55(3), pages 531-555, April.
    3. Leonard, Kenneth L., 2002. "When both states and markets fail: asymmetric information and the role of NGOs in African health care," International Review of Law and Economics, Elsevier, vol. 22(1), pages 61-80, July.
    4. Pouliot, Mariève, 2011. "Relying on nature’s pharmacy in rural Burkina Faso: Empirical evidence of the determinants of traditional medicine consumption," Social Science & Medicine, Elsevier, vol. 73(10), pages 1498-1507.
    5. Thomas Druetz & Federica Fregonese & Aristide Bado & Tieba Millogo & Seni Kouanda & Souleymane Diabaté & Slim Haddad, 2015. "Abolishing Fees at Health Centers in the Context of Community Case Management of Malaria: What Effects on Treatment-Seeking Practices for Febrile Children in Rural Burkina Faso?," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-14, October.
    6. Majumder, Amlan, 2014. "Economics of health care utilisation: a study of self-reported morbidity and health seeking patterns in the districts of Cooch Behar and Jalpaiguri, West Bengal, India," EconStor Books, ZBW - Leibniz Information Centre for Economics, number 110899.
    7. Stekelenburg, Jelle & Kyanamina, Sindele Simasiku & Wolffers, Ivan, 2003. "Poor performance of community health workers in Kalabo District, Zambia," Health Policy, Elsevier, vol. 65(2), pages 109-118, August.
    8. Riviere-Cinnamond, Ana, 2005. "Animal Health Policy and Practice: Scaling-up Community-based Animal Health Systems, Lessons from Human Health," PPLPI Working Papers 23775, Food and Agriculture Organization of the United Nations, Pro-Poor Livestock Policy Initiative.
    9. Riviere-Cinnamond, Ana, 2004. "A Public Choice Approach to the Economic Analysis of Animal Healthcare Systems," PPLPI Working Papers 23786, Food and Agriculture Organization of the United Nations, Pro-Poor Livestock Policy Initiative.
    10. Oppong, Joseph R., 1996. "Accommodating the rainy season in Third World location-allocation applications," Socio-Economic Planning Sciences, Elsevier, vol. 30(2), pages 121-137, June.
    11. Gnawali, Devendra Prasad & Pokhrel, Subhash & Sié, Ali & Sanon, Mamadou & De Allegri, Manuela & Souares, Aurélia & Dong, Hengjin & Sauerborn, Rainer, 2009. "The effect of community-based health insurance on the utilization of modern health care services: Evidence from Burkina Faso," Health Policy, Elsevier, vol. 90(2-3), pages 214-222, May.
    12. Kim, Younoh & Radoias, Vlad, 2016. "Education, individual time preferences, and asymptomatic disease detection," Social Science & Medicine, Elsevier, vol. 150(C), pages 15-22.
    13. Druetz, Thomas & Kadio, Kadidiatou & Haddad, Slim & Kouanda, Seni & Ridde, Valéry, 2015. "Do community health workers perceive mechanisms associated with the success of community case management of malaria? A qualitative study from Burkina Faso," Social Science & Medicine, Elsevier, vol. 124(C), pages 232-240.
    14. Dong, Hengjin & Mugisha, Frederick & Gbangou, Adjima & Kouyate, Bocar & Sauerborn, Rainer, 2004. "The feasibility of community-based health insurance in Burkina Faso," Health Policy, Elsevier, vol. 69(1), pages 45-53, July.

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