Spatial Analysis of a Community-based Selection on Indigents Receiving the User Fee Exemption in Burkina Faso

2nd Global Symposium on Health Systems Research, 31 October – 3 November 2012, Beijing, China

V. Riddle, E. Bonnet, A. Nikiema, and K. Kadio

“Over recent decades, Burkina Faso has improved the geographic accessibility of its health centres. However, patients are still required to pay point-of-service user fees, which excludes the most  vulnerable from access to care. In 2010, 259 village committees in the Ouargaye district selected 2649  indigents to be exempted from user fees. The 26 health centre management committees that fund this  exemption retained 1097 of those selected indigents.

“Spatial analysis showed that the management  committees retained the indigents who were geographically closer to the health centres, in contrast  to the selections of the village committees which were more diversified. Using village committees to  select indigents would seem preferable to using management committees. It is not yet known whether  the management committees’ selections were due to a desire to maximize the benefits of exemption  by giving it to those most likely to use it, or to the fact that they did not personally know the indigents  who were more geographically distant from them, or that some villages are not represented at the  management committees.”