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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

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  • V. Ridde
  • I. Agier
  • A. Jahn
  • O. Mueller
  • J. Tiendrebéogo
  • M. Yé
  • M. De Allegri

Abstract

The Burkinabè policy led to a significant and sustained reduction in household OOP health spending across all socio-economic groups, but failed to properly target the poorest by ensuring a progressive payment system. Copyright Springer-Verlag Berlin Heidelberg 2015

Suggested Citation

  • 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.
    • Handle: RePEc:spr:eujhec:v:16:y:2015:i:1:p:55-64
    DOI: 10.1007/s10198-013-0553-5
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    References listed on IDEAS

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    1. Valéry Ridde & Seni Kouanda & Aristide Bado & Nicole Bado & Slim Haddad, 2012. "Reducing the Medical Cost of Deliveries in Burkina Faso Is Good for Everyone, Including the Poor," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-8, March.
    2. Klaus Deininger & Paul Mpuga, 2005. "Economic and Welfare Impact of the Abolition of Health User Fees: Evidence from Uganda," Journal of African Economies, Centre for the Study of African Economies, vol. 14(1), pages 55-91, March.
    3. Mathauer, Inke & Carrin, Guy, 2011. "The role of institutional design and organizational practice for health financing performance and universal coverage," Health Policy, Elsevier, vol. 99(3), pages 183-192, March.
    4. Ridde, Valéry & Yaogo, Maurice & Kafando, Yamba & Kadio, Kadidiatou & Ouedraogo, Moctar & Bicaba, Abel & Haddad, Slim, 2011. "Targeting the worst-off for free health care: A process evaluation in Burkina Faso," Evaluation and Program Planning, Elsevier, vol. 34(4), pages 333-342, November.
    5. Susie Dzakpasu & Seyi Soremekun & Alexander Manu & Guus ten Asbroek & Charlotte Tawiah & Lisa Hurt & Justin Fenty & Seth Owusu-Agyei & Zelee Hill & Oona M R Campbell & Betty R Kirkwood, 2012. "Impact of Free Delivery Care on Health Facility Delivery and Insurance Coverage in Ghana’s Brong Ahafo Region," PLOS ONE, Public Library of Science, vol. 7(11), pages 1-9, November.
    6. 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.
    7. Heckman, James, 2013. "Sample selection bias as a specification error," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 31(3), pages 129-137.
    8. 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.
    9. Tin Su & Steffen Flessa, 2013. "Determinants of household direct and indirect costs: an insight for health-seeking behaviour in Burkina Faso," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 75-84, February.
    10. Xu, Ke & Evans, David B. & Kadama, Patrick & Nabyonga, Juliet & Ogwal, Peter Ogwang & Nabukhonzo, Pamela & Aguilar, Ana Mylena, 2006. "Understanding the impact of eliminating user fees: Utilization and catastrophic health expenditures in Uganda," Social Science & Medicine, Elsevier, vol. 62(4), pages 866-876, February.
    11. Mohammad Hajizadeh & Hong Nghiem, 2011. "Out-of-pocket expenditures for hospital care in Iran: who is at risk of incurring catastrophic payments?," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 267-285, December.
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    Cited by:

    1. Parmar, Divya & Banerjee, Aneesh, 2019. "How do supply- and demand-side interventions influence equity in healthcare utilisation? Evidence from maternal healthcare in Senegal," Social Science & Medicine, Elsevier, vol. 241(C).
    2. Yohan Renard, 2022. "From fees to free: User fee removal, maternal health care utilization and child health in Zambia," Post-Print hal-04216814, HAL.
    3. Meike Irene Nakovics & Stephan Brenner & Paul Jacob Robyn & Ludovic Deo Gracias Tapsoba & Manuela De Allegri, 2019. "Determinants of individual healthcare expenditure: A cross‐sectional analysis in rural Burkina Faso," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1478-1494, October.
    4. Philip Ayizem Dalinjong & Alex Y. Wang & Caroline S. E. Homer, 2017. "The operations of the free maternal care policy and out of pocket payments during childbirth in rural Northern Ghana," Health Economics Review, Springer, vol. 7(1), pages 1-9, December.
    5. Mladovsky, Philipa & Ba, Maymouna, 2017. "Removing user fees for health services: A multi-epistemological perspective on access inequities in Senegal," Social Science & Medicine, Elsevier, vol. 188(C), pages 91-99.
    6. 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.
    7. Renard, Yohan, 2022. "From fees to free: User fee removal, maternal health care utilization and child health in Zambia," World Development, Elsevier, vol. 156(C).

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    More about this item

    Keywords

    User fees; Abolition; Maternal health; Policy; Out-of-pocket spending; Burkina Faso; C01; I14; I18; I38; Z18;
    All these keywords.

    JEL classification:

    • C01 - Mathematical and Quantitative Methods - - General - - - Econometrics
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • Z18 - Other Special Topics - - Cultural Economics - - - Public Policy

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