Equity in financing and use of health care in Ghana, South Africa, and Tanzania : implications for paths to universal coverage
Effective mechanisms to exempt the indigent from user fees at health care facilities are rare in Africa. A
State-led intervention (2004–2005) and two action research projects (2007–2010) were implemented in
Burkina Faso implemented a national subsidy for emergency obstetric and
neonatal care (EmONC) covering 80% of the cost of normal childbirth in public
health facilities. The objective was to increase coverage of facility-based
In 2007, Burkina Faso launched a public policy to subsidize 80% of the cost of normal deliveries.
As countries work towards Universal Health Coverage, there is a need to design, implement, and manage provider payment methods reforms, but from a systems perspective, rather than traditional linear models.
Since 2007, Burkina Faso has subsidized 80% of the costs of childbirth. Women are required to pay 20% except for the indigent, who are exempt. The objective of the policy was to increase service utilization and reduce costs for households.
Background: User fees were generalized in Burkina Faso in the 1990 s. At the time of their implementation, it was
envisioned that measures would be instituted to exempt the poor from paying these fees. However, in practice,
HIV prevention programmes should take into account levels of social stigma, especially among the disadvantaged, and act carefully not to increase it.