Ilboudo Patrick Gueswendé, Siri Alain
African Population and Health Research Center, Nairobi, Kenya.
Secrétariat Permanent du Plan National de Développement Economique et Social (SP/PNDES), Ouagadougou, Burkina Faso.
Health Econ Rev. 2023 May 5;13(1):27. doi: 10.1186/s13561-023-00443-w.
Burkina Faso has recently instituted a free healthcare policy for women and children under five. This comprehensive study examined the effects of this policy on the use of services, health outcomes, and removal of costs.
Interrupted time-series regressions were used to investigate the effects of the policy on the use of health services and health outcomes. In addition, an analysis of household expenditures was conducted to assess the effects of spending on delivery, care for children, and other exempted (antenatal, postnatal, etc.) services on household expenditures.
The findings show that the user fee removal policy significantly increased the use of healthcare facilities for child consultations and reduced mortality from severe malaria in children under the age of five years. It also has increased the use of health facilities for assisted deliveries, complicated deliveries, and second antenatal visits, and reduced cesarean deliveries and intrahospital infant mortality, although not significantly. While the policy has failed to remove all costs, it decreased household costs to some extent. In addition, the effects of the user fee removal policy seemed higher in districts with non-compromised security for most of the studied indicators.
Given the positive effects, the findings of this investigation support the pursuit of implementing the free healthcare policy for maternal and child care.
布基纳法索最近为妇女和五岁以下儿童制定了免费医疗政策。这项全面研究考察了该政策对服务利用、健康结果和成本消除的影响。
采用中断时间序列回归来研究该政策对医疗服务利用和健康结果的影响。此外，还对家庭支出进行了分析，以评估分娩、儿童护理及其他豁免（产前、产后等）服务支出对家庭支出的影响。
研究结果表明，取消用户费用政策显著增加了儿童咨询的医疗设施使用量，并降低了五岁以下儿童因严重疟疾导致的死亡率。该政策还增加了助产、复杂分娩和第二次产前检查的医疗设施使用量，并降低了剖宫产率和院内婴儿死亡率，尽管降幅不显著。虽然该政策未能消除所有成本，但在一定程度上降低了家庭成本。此外，对于大多数研究指标而言，取消用户费用政策在安全无虞的地区效果似乎更佳。
鉴于这些积极影响，本调查结果支持推行母婴护理免费医疗政策。
