Free healthcare for pregnant women and children <5 years

Background

The health of pregnant women and young children remains precarious in Burkina Faso. In 2010, the World Health Organization (WHO) estimated maternal and infant (under-five) mortality at 560 and 166 per 100,000 live births respectively. Only one in two children was taken to a health centre when it fell ill. Inequalities in terms of access to health services persist. It is against this backdrop that the government of Burkina Faso has taken steps to remove financial barriers to access to healthcare. Free healthcare for pregnant women and children under five is an important step towards universal health coverage, making it possible to provide full support for 25% of the Burkinabe population, i.e. around 5 million people.

Description

Free care for pregnant women and children under the age of five provides for coverage of the direct costs of curative treatment in the various health structures and public health centres: health and social promotion centres (CSPS); medical centres with a surgical wing (CMA); regional health centres (CHR) and university hospitals (CHU). The following costs are covered:

• Maternity costs (births, including caesarean sections; care during pregnancy, additional examinations, etc.)
• Care for children under five years of age
• Family planning (since June 2019)
• Hospitalisation
• Medicines
• Fuel for medical evacuations

Impacts

The use of health services by the target groups has increased significantly. In 2018, the Ministry of Health recorded 6.2 million free healthcare sessions for a total cost of XOF 9.6 billion (EUR 14.8 million).

Impacts

• Increased use of health services
• Significant reduction in delays in consultation
• Increase in the number of assisted childbirths
• Downturn in maternal and child mortality
• Improved health of women and children
• Improved household living standards

Success factors

• Strong political will to ensure sustainable financing
• Buy-in and motivation of healthcare personnel
• Information and training of the different actors
• Availability of medicines and consumables
• Modernisation of facilities and the health information system
• Enhanced prevention and healthcare promotion programmes

Challenges

• Implementation of a sustainable financing mechanism
• Availability of medicines and consumables in health centres
• Promotion/communication on free healthcare to targeted vulnerable groups
• Improved facilities and modernisation of health structures (medical and technical equipment, development of the health information system, better monitoring and control of drug management)

LESSONS LEARNED

• Better organisation of healthcare services improves the outcomes of free care
• The strong involvement of all stakeholders in the decision-making process facilitates the implementation of the measure at the local and national level.
• Interruptions in the supply of medicines and consumables jeopardise the success of the operation

Scaling-up

The practice is in place in all the health and social promotion centres (CSPS) in Burkina Faso. That said, there are still issues with its implementation in some areas, notably due to interruptions in the supply of medicines and consumables. Almost all Sahelian and West African countries have introduced free measures to improve child and maternal health. It would be useful to improve the sharing of lessons learned and best practices.

Organisation/s

Ministry of Health

Partner/s

NGOs, OSCNICEF, SE-CNSA and TFP

Contact

Mr Pierre Yaméogo, Secrétaire technique chargé de la couverture sanitaire universelle