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Do Targeted User Fee Exemptions Reach the Ultra-Poor and Increase their Healthcare Utilisation? A Panel Study from Burkina Faso

Author

Listed:
  • Yvonne Beaugé

    (Heidelberg Institute for Global Health, Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 365, 69120 Heidelberg, Germany)

  • Manuela De Allegri

    (Heidelberg Institute for Global Health, Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 365, 69120 Heidelberg, Germany)

  • Samiratou Ouédraogo

    (The Canadian Institutes of Health Research (CIHR), Ottawa, ON K1A 0W9, Canada
    National Public Health Institute of Quebec (INSPQ), Quebec City, QC G1V 5B3, Canada
    Department of Epidemiology, Biostatistics and Occupational Health (EBOH), Faculty of Medicine, McGill University, Montreal, QC H3A 1A2, Canada)

  • Emmanuel Bonnet

    (French Institute for Research on Sustainable Development (IRD), Unité Mixte Internationale (UMI) Résiliences, 93143 Bondy, France)

  • Naasegnibe Kuunibe

    (Heidelberg Institute for Global Health, Medical Faculty and University Hospital, Heidelberg University, Im Neuenheimer Feld 365, 69120 Heidelberg, Germany
    Department of Economics and Entrepreneurship Development Studies, Faculty of Integrated Development Studies, University for Development Studies, P. O. Box 520, Wa, Upper West Region, Ghana)

  • Valéry Ridde

    (French Institute for Research on sustainable Development (IRD), Centre Population et Développement (CEPED), Universités de Paris, ERL INSERM SAGESUD, 75006 Paris, France)

Abstract

Background: A component of the performance-based financing intervention implemented in Burkina Faso was to provide free access to healthcare via the distribution of user fee exemption cards to previously identified ultra-poor. This study examines the factors that led to the receipt of user fee exemption cards, and the effect of card possession on the utilisation of healthcare services. Methods: A panel data set of 1652 randomly selected ultra-poor individuals was used. Logistic regression was applied on the end line data to identify factors associated with the receipt of user fee exemption cards. Random-effects modelling was applied to the panel data to determine the effect of the card possession on healthcare service utilisation among those who reported an illness six months before the surveys. Results: Out of the ultra-poor surveyed in 2017, 75.51% received exemption cards. Basic literacy ( p = 0.03), living within 5 km from a healthcare centre ( p = 0.02) and being resident in Diébougou or Gourcy ( p = 0.00) were positively associated with card possession. Card possession did not increase health service utilisation (β = −0.07; 95% CI = −0.45; 0.32; p = 0.73). Conclusion: A better intervention design and implementation is required. Complementing demand-side strategies could guide the ultra-poor in overcoming all barriers to healthcare access.

Suggested Citation

  • Yvonne Beaugé & Manuela De Allegri & Samiratou Ouédraogo & Emmanuel Bonnet & Naasegnibe Kuunibe & Valéry Ridde, 2020. "Do Targeted User Fee Exemptions Reach the Ultra-Poor and Increase their Healthcare Utilisation? A Panel Study from Burkina Faso," IJERPH, MDPI, vol. 17(18), pages 1-21, September.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:18:p:6543-:d:410731
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    References listed on IDEAS

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    1. Lohmann, Julia & Koulidiati, Jean-Louis & Robyn, Paul Jacob & Somé, Paul-André & De Allegri, Manuela, 2022. "Why did performance-based financing in Burkina Faso fail to achieve the intended equity effects? A process tracing study," Social Science & Medicine, Elsevier, vol. 305(C).

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