Département de Médecine Sociale et Préventive, Université de Montréal, Canada.
Glob Health Promot. 2013 Mar;20(1 Suppl):10-9. doi: 10.1177/1757975912462417.
Over recent decades, Burkina Faso has improved the geographic accessibility of its health centres. However, patients are still required to pay point-of-service user fees, which excludes the most vulnerable from access to care. In 2010, 259 village committees in the Ouargaye district selected 2649 indigents to be exempted from user fees. The 26 health centre management committees that fund this exemption retained 1097 of those selected indigents. Spatial analysis showed that the management committees retained the indigents who were geographically closer to the health centres, in contrast to the selections of the village committees which were more diversified. Using village committees to select indigents would seem preferable to using management committees. It is not yet known whether the management committees' selections were due to a desire to maximize the benefits of exemption by giving it to those most likely to use it, or to the fact that they did not personally know the indigents who were more geographically distant from them, or that some villages are not represented at the management committees.
近几十年来，布基纳法索提高了卫生中心的地理可达性。然而，患者仍需支付服务点自付费用，这使最弱势群体无法获得医疗服务。2010 年，瓦加杜古地区的 259 个村委员会选择了 2649 名贫困者免除自付费用。为该豁免提供资金的 26 个卫生中心管理委员会保留了其中 1097 名选定的贫困者。空间分析表明，管理委员会保留了地理位置更接近卫生中心的贫困者，而不是村委员会更具多样性的选择。使用村委员会来选择贫困者似乎比使用管理委员会更好。目前尚不清楚管理委员会的选择是因为希望通过将豁免权给予最有可能使用它的人来最大化豁免的好处，还是因为他们不认识那些地理位置更远的贫困者，或者是因为有些村庄在管理委员会中没有代表。
