Poster presented by Anthony Lacouture, at the ” KT Canada Summer Institute on Knowledge Translation : Knowledge Translation for 4 Ps (patients, providers, public and policymakers), which took place from 9th to 11th of june in Québéc, Canada. (more…)
New article published in International Journal for Equity in Health
A book chapter will also be publish soon (french only)
To increase the financial access to health care for indigents, an action research was conducted in Burkina Faso. Based on a community approach, village committees identified indigents who were exempt from payment of health care fees. Quantitative analysis of the food expenditure of selected households (to assess the efficacy of the community-based selection) showed that some of the indigents selected came from households with a high economic level. This research was designed to explain why these people were identified by the Village Selection Committees (VSC).
This study was based on a qualitative exploratory descriptive approach, complementary and subsequent to a quantitative study. Life stories and individual interviews were conducted with stratified random sampling of 54 indigents. Thematic content analysis was performed.
Indigents identified by the community are usually elderly, unable to work because of old age or chronic illness. However, some of them came from households with a high level of consumption, which can be explained by the fact that they benefit from community aid for their food needs. However, they present persistent difficulties of access to health care.
Discussion: The community perceives poverty in terms other simply economic aspects. The social dimension of poverty (including the inability to fully participate in community life) has a major impact on the choice of the CVS, leading to the selection of indigents from households that appear to have a high economic level. This community process which takes into account contextual factors, identified these people who do not necessarily have access to the household resources for health care.
We are now repairing broken links to all files. If you need access to some documents, please write to us for a quick response. Thank you for you patience!
It’s time for spring cleaning. We wish to offer you smoother navigation and new content! equitesante.org will undergo maintenance from Wednesday March 19 at 13:00 to Saturday March 22 at 01:00 (UTC/GMT -4 hours).
Thank you for your patience. If you have questions or wish to access documents during that period, please contact us.
equitesante.org will undergo maintenance on Friday, February 28 from 10:00 to 15:00 (Standard Eastern Time). Thank you for your patience. If you have questions, please write to us!
Hunt, M. R., Gogognon, P., & Ridde, V. (2014). Ethical considerations related to participation and partnership: an investigation of stakeholders’ perceptions of an action-research project on user fee removal for the poorest in Burkina Faso. BMC Medical Ethics, 15(1), 13. doi:10.1186/1472-6939-15-13. [html]
Healthcare user fees present an important barrier for accessing services for the poorest (indigents) in Burkina Faso and selective removal of fees has been incorporated in national healthcare planning. However, establishing fair, effective and sustainable mechanisms for the removal of user fees presents important challenges. A participatory action-research project was conducted in Ouargaye, Burkina Faso, to test mechanisms for identifying those who are indigents, and funding and implementing user fee removal. In this paper, we explore stakeholder perceptions of ethical considerations relating to participation and partnership arising in the action-research.
We conducted 39 in-depth interviews to examine ethical issues associated with the action-research. Respondents included 14 individuals identified as indigent through the community selection process, seven members of village selection committees, six local healthcare professionals, five members of the management committees of local health clinics, five members of the research team, and four regional or national policy-makers. Using constant comparative techniques, we carried out an inductive thematic analysis of the collected data.
The Ouargaye project involved a participatory model, included both implementation and research components, and focused on a vulnerable group within small, rural communities. Stakeholder perceptions and experiences relating to the participatory approach and reliance on multiple partnerships in the project were associated with a range of ethical considerations related to 1) seeking common ground through communication and collaboration, 2) community participation and risk of stigmatization, 3) impacts of local funding of the user fee removal, 4) efforts to promote fairness in the selection of the indigents, and 5) power relations and the development of partnerships.
This investigation of the Ouargaye project serves to illuminate the distinctive ethical terrain of a participatory public health action-research project. In carrying out such projects, careful attention and effort is needed to establish and maintain respectful relationships amongst those involved, acknowledge and address differences of power and position, and evaluate burdens and risks for individuals and groups.