Research Centre of the University of Montreal Hospital Centre (CRCHUM), Montreal, Quebec, Canada.
Trop Med Int Health. 2012 Jun;17(6):782-91. doi: 10.1111/j.1365-3156.2012.02991.x. Epub 2012 Apr 19.
Universal healthcare coverage cannot be achieved in Africa as long as the indigent, the poorest, are unable to access healthcare systems. This study was carried out in Burkina Faso to obtain street-level workers' perspectives on what criteria should be used to select indigents to be exempted from user fees.
Two group consensus techniques were used (Delphi and Concept Mapping). The participants were nurses (CM; n = 24), midwives (CM; n = 23) from a rural district and Social Action agents (CM; n = 31) and healthcare workers (Delphi n = 23) in training at two national schools.
Altogether, 446 criteria were proposed. The nurses put forward criteria related to being ill without support and being a victim of society. The midwives focused more on the disabled poor and those who were ill and unsupported. The healthcare workers in training mentioned disabled persons and the elderly with no family support. The Social Action agents spoke about vulnerability related to illness or disability and the fact of being excluded or being a disaster victim.
These criteria proposed by street-level workers add to other studies conducted in Burkina Faso and should help the State to improve indigents' access to care.
只要贫困人群，即最贫困的人无法获得医疗保健系统，非洲就无法实现全民医疗保健覆盖。本研究在布基纳法索进行，旨在了解基层工作者认为应使用哪些标准来选择免除医疗费用的贫困人群。
采用了两种小组共识技术（德尔菲法和概念映射法）。参与者包括来自农村地区的护士（CM，n=24）、助产士（CM，n=23）和社会行动代理人（CM，n=31）以及在两所国立学校接受培训的医疗保健工作者（德尔菲法，n=23）。
共提出了 446 条标准。护士提出的标准涉及没有支持的疾病和社会受害者。助产士更关注残疾贫困者、患病且无人支持的人。培训中的医疗保健工作者提到了没有家庭支持的残疾人和老年人。社会行动代理人则提到了与疾病或残疾有关的脆弱性，以及被排斥或成为灾难受害者的事实。
这些基层工作者提出的标准补充了在布基纳法索进行的其他研究，应有助于国家改善贫困人群获得医疗服务的机会。
