Targeting the worst-off for free health care: A process evaluation in Burkina Faso

Valéry Ridde, Maurice Yaogo, Yamba Kafando, Kadidiatou Kadio, Moctar Ouedraogo, Abel Bicaba and Slim Haddad

Evaluation and Program Planning, 2011, vol. 34, issue 4, 333-342

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.

Keywords: Exemption; Worst-off; Targeting; Process; evaluation; Burkina; Faso (search for similar items in EconPapers)
Date: 2011
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S0149718911000310
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:epplan:v:34:y:2011:i:4:p:333-342

Access Statistics for this article

Evaluation and Program Planning is currently edited by Jonathan A. Morell

More articles in Evaluation and Program Planning from Elsevier
Bibliographic data for series maintained by Catherine Liu ().