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How Burkina Faso used evidence in deciding to launch its policy of free healthcare for children under five and women in 2016

Author

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  • Valéry Ridde

    (CEPED (IRD-Université Paris Descartes), Universités Paris Sorbonne Cités, ERL INSERM SAGESUD)

  • Pierre Yaméogo

    (Universal Health Coverage Office)

Abstract

In March 2016, the newly elected government of Burkina Faso decided on a major change in health financing policy: it abolished direct payment for healthcare for women and children under five. Unlike other countries in Africa, this decision took a long time, given that the first pilot projects for this policy instrument date from 2008. This article describes that political process and presents a reflexive analysis by two authors who were at the heart of events between 2008 and 2018. The analysis shows that, while the decision took a long time and certainly amounted to a policy paradigm shift, it was the result of a complex series of events and activities whose specific contributions are difficult to identify. Crucial to the decision was long-term funding of pilot projects to test the new policy instrument, associated with the generation of evidence mobilised through a myriad of knowledge transfer activities. Moreover, it took the continued mobilisation of advocacy coalitions, action to counter preconceived notions about this instrument, and the emergence of an essential window of opportunity—the 2014 popular uprising—for the decision to be possible. In this discussion, we generalise to the conceptual and theoretical levels, but also share practical lessons learned for those interested in engaging in evidence-informed decision-making. The main lessons are: recruit, train, and mobilise people and/or services responsible for knowledge transfer activities; identify and partner with political entrepreneurs early and regularly; be persistent and consistent in producing rigorous and useful knowledge; favour independent evaluation teams using mixed methods; train researchers in policy decision-making processes and decision-makers in knowledge production issues; adapt (content, format, vocabulary, language, etc.) the evidence to the needs of the knowledge users in close collaboration with researchers and disseminate it to target audiences; understand the sometimes different logics of researchers and decision-makers and encourage their interaction; to seize opportunities, regularly analyse the political decision-making processes specific to the national context as well as the social and political contexts favourable (or not) to decision-making.

Suggested Citation

  • Valéry Ridde & Pierre Yaméogo, 2018. "How Burkina Faso used evidence in deciding to launch its policy of free healthcare for children under five and women in 2016," Palgrave Communications, Palgrave Macmillan, vol. 4(1), pages 1-9, December.
    • Handle: RePEc:pal:palcom:v:4:y:2018:i:1:d:10.1057_s41599-018-0173-x
    DOI: 10.1057/s41599-018-0173-x
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    References listed on IDEAS

    as
    1. Chemouni, Benjamin, 2018. "The political path to universal health coverage: Power, ideas and community-based health insurance in Rwanda," World Development, Elsevier, vol. 106(C), pages 87-98.
    2. World Health Organization & World Bank, 2017. "Tracking Universal Health Coverage," World Bank Publications - Books, The World Bank Group, number 29042, December.
    3. Ridde, Valéry, 2008. ""The problem of the worst-off is dealt with after all other issues": The equity and health policy implementation gap in Burkina Faso," Social Science & Medicine, Elsevier, vol. 66(6), pages 1368-1378, March.
    4. V. Ridde & I. Agier & A. Jahn & O. Mueller & J. Tiendrebéogo & M. Yé & M. De Allegri, 2015. "The impact of user fee removal policies on household out-of-pocket spending: evidence against the inverse equity hypothesis from a population based study in Burkina Faso," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(1), pages 55-64, January.
    5. Paul Cairney & Richard Kwiatkowski, 2017. "How to communicate effectively with policymakers: combine insights from psychology and policy studies," Palgrave Communications, Palgrave Macmillan, vol. 3(1), pages 1-8, December.
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    Cited by:

    1. Yvonne Beaugé & Manuela De Allegri & Samiratou Ouédraogo & Emmanuel Bonnet & Naasegnibe Kuunibe & Valéry Ridde, 2020. "Do Targeted User Fee Exemptions Reach the Ultra-Poor and Increase their Healthcare Utilisation? A Panel Study from Burkina Faso," IJERPH, MDPI, vol. 17(18), pages 1-21, September.
    2. Ruth Stewart & Harsha Dayal & Laurenz Langer & Carina van Rooyen, 2019. "The evidence ecosystem in South Africa: growing resilience and institutionalisation of evidence use," Palgrave Communications, Palgrave Macmillan, vol. 5(1), pages 1-12, December.
    3. Esther Mc Sween-Cadieux & Christian Dagenais & Donmozoun Télesphore Somé & Valéry Ridde, 2019. "A health knowledge brokering intervention in a district of Burkina Faso: A qualitative retrospective implementation analysis," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-21, July.

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