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Determinants of utilisation of maternal care services after the reduction of user fees: A case study from rural Burkina Faso

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  • De Allegri, Manuela
  • Ridde, Valéry
  • Louis, Valérie R.
  • Sarker, Malabika
  • Tiendrebéogo, Justin
  • Yé, Maurice
  • Müller, Olaf
  • Jahn, Albrecht

Abstract

Objective To identify determinants of utilisation for antenatal care (ANC) and skilled attendance at birth after a substantial reduction in user fees.Methods The study was conducted in the Nouna Health District in north-western Burkina Faso in early 2009. Data was collected by means of a representative survey on a sample of 435 women who reported a pregnancy in the prior 12 months. Two independent logit models were used to assess the determinants of (a) ANC utilisation (defined as having attended at least 3 visits) and (b) skilled assistance at birth (defined as having delivered in a health facility).Results 76% of women had attended at least 3 ANC visits and 72% had delivered in a facility. Living within 5Â km from a facility was positively associated, while animist religion, some ethnicities, and household wealth were negatively associated with ANC utilisation. Some ethnicities, living within 5Â km from a health facility, and having attended at least 3 ANC visits were positively associated with delivering in a facility.Conclusions User fee alleviation secured equitable access to care across socio-economic groups, but alone did not ensure that all women benefited from ANC and from skilled attendance at birth. Investments in policies to address barriers beyond financial ones are urgently needed.

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  • De Allegri, Manuela & Ridde, Valéry & Louis, Valérie R. & Sarker, Malabika & Tiendrebéogo, Justin & Yé, Maurice & Müller, Olaf & Jahn, Albrecht, 2011. "Determinants of utilisation of maternal care services after the reduction of user fees: A case study from rural Burkina Faso," Health Policy, Elsevier, vol. 99(3), pages 210-218, March.
    • Handle: RePEc:eee:hepoli:v:99:y:2011:i:3:p:210-218
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    2. Laura K. Merrell & Sarah R. Blackstone, 2020. "Women’s Empowerment as a Mitigating Factor for Improved Antenatal Care Quality despite Impact of 2014 Ebola Outbreak in Guinea," IJERPH, MDPI, vol. 17(21), pages 1-18, November.
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    5. Thierry Bastelaer & Benjamin Woodman & Minki Chatterji & David Long, 2016. "Saving for delivery through technology: an inquiry into an electronic commitment savings product for maternal healthcare in Kenya," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(4), pages 254-272, October.
    6. Laura Treacy & Håkon A Bolkan & Mette Sagbakken, 2018. "Distance, accessibility and costs. Decision-making during childbirth in rural Sierra Leone: A qualitative study," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-17, February.
    7. Chitalu M. Chama-Chiliba & Steven F. Koch, 2014. "Assessing regional variation in the effect of the removal of user fees on institutional deliveries in rural Zambia," Working Papers 427, Economic Research Southern Africa.
    8. HakemZadeh, Farimah & Sayin, Firat K. & Neiterman, Elena & Zeytinoglu, Isik Urla & Geraci, Johanna & Plenderleith, Jennifer & Lobb, Derek, 2021. "Does an alignment of employment policies and individual preferences affect intention to stay in the profession? Evidence from Canadian Midwives," Health Policy, Elsevier, vol. 125(4), pages 450-458.
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    10. Idrissa Beogo & Chieh-Yu Liu & Yiing-Jenq Chou & Chuan-Yu Chen & Nicole Huang, 2014. "Health-Care-Seeking Patterns in the Emerging Private Sector in Burkina Faso: A Population-Based Study of Urban Adult Residents in Ouagadougou," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-11, May.
    11. Adjiwanou, Vissého & LeGrand, Thomas, 2013. "Does antenatal care matter in the use of skilled birth attendance in rural Africa: A multi-country analysis," Social Science & Medicine, Elsevier, vol. 86(C), pages 26-34.
    12. Guliani, Harminder & Sepehri, Ardeshir & Serieux, John, 2012. "What impact does contact with the prenatal care system have on women’s use of facility delivery? Evidence from low-income countries," Social Science & Medicine, Elsevier, vol. 74(12), pages 1882-1890.
    13. Alagidede, Paul & Baah-Boateng, William & Nketiah-Amponsah, Edward, 2013. "The Ghanian economy: and Overview," MPRA Paper 109687, University Library of Munich, Germany.
    14. Mampi Bose, 2019. "Determinants of Choice of Care Providers During Childbirth in Rural West Bengal, India," Indian Journal of Human Development, , vol. 13(1), pages 47-70, April.
    15. Gemignani, Regina & Tsimpo, Clarence & Wodon, Quentin, 2012. "Making quality care available for the poor: faith-inspired health facilities in Burkina Faso," MPRA Paper 45389, University Library of Munich, Germany.
    16. Druetz, Thomas & Bicaba, Abel & Some, Telesphore & Kouanda, Seni & Ly, Antarou & Haddad, Slim, 2017. "Effect of interrupting free healthcare for children: Drawing lessons at the critical moment of national scale-up in Burkina Faso," Social Science & Medicine, Elsevier, vol. 185(C), pages 46-53.
    17. Yaovi Tossou, 2021. "Prenatal consultation and survival of children under five in Togo," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(6), pages 2336-2350, November.
    18. Gemignani, Regina & Wodon, Quentin, 2012. "How do households choose between health providers? results from qualitative fieldwork in Burkina Faso," MPRA Paper 45375, University Library of Munich, Germany.
    19. Gerald Manthalu, 2019. "User fee exemption and maternal health care utilisation at mission health facilities in Malawi: An application of disequilibrium theory of demand and supply," Health Economics, John Wiley & Sons, Ltd., vol. 28(4), pages 461-474, April.
    20. Teketo Kassaw Tegegne & Catherine Chojenta & Deborah Loxton & Roger Smith & Kelemu Tilahun Kibret, 2018. "The impact of geographic access on institutional delivery care use in low and middle-income countries: Systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-16, August.

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