Determinants of utilisation of maternal care services after the reduction of user fees: A case study from rural Burkina Faso
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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- Brazier, Ellen & Andrzejewski, Catherine & Perkins, Margaret E. & Themmen, Ellen M. & Knight, Rodney J. & Bassane, Brahima, 2009. "Improving poor women's access to maternity care: Findings from a primary care intervention in Burkina Faso," Social Science & Medicine, Elsevier, vol. 69(5), pages 682-690, September.
- Gage, Anastasia J., 2007. "Barriers to the utilization of maternal health care in rural Mali," Social Science & Medicine, Elsevier, vol. 65(8), pages 1666-1682, October.
- Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 115-132, February.
- Onah, Hyacinth Eze & Ikeako, Lawrence C. & Iloabachie, Gabriel C., 2006. "Factors associated with the use of maternity services in Enugu, southeastern Nigeria," Social Science & Medicine, Elsevier, vol. 63(7), pages 1870-1878, October.
- Magadi, Monica Akinyi & Madise, Nyovani Janet & Rodrigues, Roberto Nascimento, 2000. "Frequency and timing of antenatal care in Kenya: explaining the variations between women of different communities," Social Science & Medicine, Elsevier, vol. 51(4), pages 551-561, August.
- Hengjin Dong & Adjima Gbangou & Manuela Allegri & Subhash Pokhrel & Rainer Sauerborn, 2008. "The differences in characteristics between health-care users and non-users: implication for introducing community-based health insurance in Burkina Faso," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 9(1), pages 41-50, February.
- Jewkes, Rachel & Abrahams, Naeemah & Mvo, Zodumo, 1998. "Why do nurses abuse patients? Reflections from South African obstetric services," Social Science & Medicine, Elsevier, vol. 47(11), pages 1781-1795, December.
- Tin Su & Subhash Pokhrel & Adjima Gbangou & Steffen Flessa, 2006. "Determinants of household health expenditure on western institutional health care," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(3), pages 195-203, September.
- Pokhrel, Subhash & De Allegri, Manuela & Gbangou, Adijma & Sauerborn, Rainer, 2010. "Illness reporting and demand for medical care in rural Burkina Faso," Social Science & Medicine, Elsevier, vol. 70(11), pages 1693-1700, June.
- Gabriela Flores & Jaya Krishnakumar & Owen O'Donnell & Eddy van Doorslaer, 2008. "Coping with health-care costs: implications for the measurement of catastrophic expenditures and poverty," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1393-1412.
- McPake, Barbara, 1993. "User charges for health services in developing countries: A review of the economic literature," Social Science & Medicine, Elsevier, vol. 36(11), pages 1397-1405, June.
- Thaddeus, Sereen & Maine, Deborah, 1994. "Too far to walk: Maternal mortality in context," Social Science & Medicine, Elsevier, vol. 38(8), pages 1091-1110, April.
- Prata, Ndola & Greig, Fiona & Walsh, Julia & West, Anna, 2004. "Ability to pay for maternal health services: what will it take to meet who standards?," Health Policy, Elsevier, vol. 70(2), pages 163-174, November.
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