POPLINE Document Number: 313773
Author(s):
Richard F
Ouedraogo C
Compaore J
Dubourg D
De Brouwere V
Source citation:
Tropical Medicine and International Health, 2007 Aug;12(8):972-981.
Abstract:
The objective was to describe the implementation of a cost-sharing system for emergency obstetric care in an urban health district of Ouagadougou, Burkina Faso and analyse its results after 1 year of activity. Service availability and use, service quality, knowledge of the cost-sharing system in the community and financial viability of the system were measured before and after the system was implemented. Different sources of data were used: community survey, anthropological study, routine data from hospital files and registers and specific data collected on major obstetric interventions (MOI) in all the hospitals utilized by the district population. Direct costs of MOI were collected for each patient through an individual form and monitored during the year 2005. Rates of MOI for absolute maternal indications (AMI) were calculated for the period 2003-2005. The direct cost of a MOI was on average 136US$, including referral cost. Through the costsharing system this amount was shared between families (46US$), health centres (15US$), Ministry of Health (38US$) and local authority (37US$). The scheme was started in January 2005. The rate of cost recovery was 91.3% and the balance at the end of 2005 was slightly positive (4.7% of the total contribution). The number of emergency referrals by health centres increased from 84 in 2004 to 683 in 2005. MOI per 100 expected births increased from 1.95% in 2003 to 3.56% in 2005 and MOI for AMI increased from 0.75% to 1.42%. The dramatic increase in MOI suggests that the cost-sharing scheme decreased financial and geographical barriers to emergency obstetric care. Other positive effects on quality of care were documented but the sustainability of such a system remains uncertain in the dynamic context of Burkina Faso (decentralization). (author's)
Keywords:
Burkina FasoIndex page
Research Report
Pre-Post Tests
Obstetrics
Obstetrical Surgery
Emergency Services
Community Financing
Economic Factors
Quality of Health Care
Implementation
Program Accessibility
Program Efficiency
Program Evaluation
Program Sustainability
Developing Countries
Africa, Western
Africa, Sub Saharan
Africa
Programs
Organization and Administration
Medicine
Health Services
Delivery of Health Care
Health
Surgery
Treatment
Medical Procedures
Financial Activities
Health Services Evaluation