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

Yvonne Beaugé, Manuela De Allegri, Samiratou Ouédraogo, Emmanuel Bonnet, Naasegnibe Kuunibe and Valéry Ridde
Additional contact information
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
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
Valéry Ridde: French Institute for Research on sustainable Development (IRD), Centre Population et Développement (CEPED), Universités de Paris, ERL INSERM SAGESUD, 75006 Paris, France

IJERPH, 2020, vol. 17, issue 18, 1-21

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.

Keywords: user fee exemptions; targeting; health service utilisation; performance-based financing; Burkina Faso (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:17:y:2020:i:18:p:6543-:d:410731

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