Access to health care for the ‘worst-off’ in Burkina Faso: 15 years of research

This presentation is an attempt to summarize some of the major evidences that Valéry Ridde and his colleagues have accumulated the past 15 years of research on access to health care for the ‘worst-off’ in Burkina Faso. It was presented at the 9th European Congress on Tropical Medicine and International Health.

Nine misconceptions about free healthcare in sub-Saharan Africa


As universal healthcare gains political momentum, there is a growing international consensus against charging user fees at the point of healthcare delivery. In 1994, South Africa launched the wave of new user fees abolition policies in Africa. In 2010, both the African Union and the UN Secretary General called for free healthcare at the point of service for children under five and pregnant women. However, dismantling a user fees policy that has been in place for over 30 years is no easy task. Not only does expanding free healthcare policies routinely lead to controversy that generally arises when public policies are badly planned, underfunded, and poorly implemented, but certain groups of actors also perceive this move as a threat. However, in most cases, the continued reluctance to make healthcare free in Africa is based not on strong evidence, but rather on misconceptions around the very notion of free care. In this paper, we address nine such misconceptions about free healthcare and provide recent evidence from Africa showing the benefit of eliminating user fees for patients. Our aim is to demonstrate that when free care is properly financed and implemented, which in itself is a major challenge, certain perceptions about the principle of free healthcare turn out to be misconceptions.

View full article:

Valéry Ridde, Ludovic Queuille, Marame Ndour. (2014). Nine misconceptions about free healthcare in sub-Saharan Africa. Development Studies Research: An Open Access Journal, Volume 1(Issue 1), pages 54-63. Download

Access to healthcare for vulnerable groups – Partners

Access to healthcare for vulnerable groups in West Africa

Our partners

HELP Allemagne

Help is a non-governmental humanitarian aid organization. It has been supporting people in distress, regardless of origin, religion, or ideology, for more than 30 years. The major pillars of its work are emergency assistance, development aid, and rehabilitation projects. Help operates in many countries of the world thanks to private donations and funding from the German government, the European Union, the United Nations, and other international funding agencies.FB-f-Logo__blue_29

Logo CR CHUMThe goal of the  University of Montreal Hospital Research Centre (CRCHUM) is to improve population health through a continuum of high-caliber university-based research. The Centre has more than 360 researchers and 450 students. Its global health research activities deal with topics related to the evaluation of health system transformations (service provision and mechanisms to improve access to services) and to public health programs worldwide aimed at analyzing the links between poverty and health and at reducing the burden of illness (HIV-AIDS, maternal mortality). Valéry Ridde is also a professor in the Department of Social and Preventive Medicine at the University of Montreal and a CIHR New Investigator(2010-2015).

Logo ECHOThe European Union is the foremost donor of humanitarian aid in the world. Together, the European Commission and the governments of the 27 member states fund more than 50% of all institutional humanitarian aid globally. ECHO is the European Community Humanitarian Office. The Office is made up of a multinational staff working in Brussels and in the field in nearly 40 offices set up in or near crisis zones. In Africa’s Sahel region, ECHO is conducting a far-reaching program, through a variety of NGOs and United Nations agencies, that involves a multi-year and multi-sectoral plan to overcome malnutrition, and the present partnership operates within the scope of that program. A video on the ECHO website shows the scientific results coming out of this partnership.

Armoiries du Burkina FasoBurkina Faso’s Ministry of Health defines and directs health policy, which is supervised in the regions by the regional health departments (DRS) and implemented by the health districts (DS) and front-line healthcare centers, which are most often managed by nurses. The key partners in this project are the DRS of Sahel, the DSs of Dori and Sebba, and the community management committees (COGES) of the healthcare centers in these two districts, as well as their healthcare teams. These COGESs represent the people.

Access to healthcare for vulnerable groups in West Africa

Access to healthcare for vulnerable groups in West Africa

HELP Allemagne


In West Africa, the health status of the population is precarious, particularly because of very poor access to healthcare services. In 2008, the European Community Humanitarian Office (ECHO), the German NGO Help, and the Direction régionale de la santé (DRS) du Sahel in Burkina Faso decided to experiment with user fee exemptions for children under five and pregnant or breastfeeding women. The project’s two objectives are to:

  • provide medical treatment for vulnerable populations;
  • improve the national health policy.

The project has four components:

  • the intervention itself (subsidy for care provided to these vulnerable populations and measures to support this subsidy);
  • evaluative research on the intervention;
  • transfer and dissemination of the knowledge produced by the intervention;
  • advocacy for policy change.

For the research and knowledge transfer activities, the project established a scientific partnership with the University of Montreal Hospital Research Centre (CRCHUM), and in particular, with Professor Valéry Ridde as scientific advisor. The CRCHUM’s research and knowledge transfer mandate, which it carries out in collaboration with the other partners, includes 1) identifying knowledge needs and setting priorities, 2) producing knowledge, 3) disseminating that knowledge, and 4) conducting activities to encourage its use.


Latest researches & publications

Out-of-pocket payments in the context of a free maternal health care policy in Burkina Faso: a national cross-sectional survey

This article presents the results of a study conducted by Ivlabèhiré Bertrand Meda, Adama Baguiya, Valéry Ridde, Henri Gautier Ouédraogo, Alexandre Dumont and Seni Kouanda in 2016 in Burkina Faso following the implementation of a free health care policy for women. It was published in Health Economics Review in march 2019.  read more…

HSR 2018 Liverpool: a summary of our interventions on health systems research

The Global Symposium on Health Systems Research is organized every two years by Health Systems Global to bring together the full range of players involved in health systems and policy research and practice. Valéry Ridde and several collaborators, researchers and students, presented some of their work at the Fifth Global Symposium on Health Systems Research (HSR2018) held in Liverpool from October 8th to October 12h, 2018. All the presentations are available hereunder. read more…

Performance-based financing in low-income and middle-income countries: isn’t it time for a rethink?

Performance-based financing in low-income and middle-income countries: isn’t it time for a rethink?This article is a collaboration between researchers, academics and public health experts from Europe, North America and Africa, working with recipient governments, in research centres and donor organisations, or as individual experts. It presents a critical perspective on how performance-based financing (PBF) is actually implemented and questions the view that PBF in the health sector is an effective, efficient and equitable approach to improving the performance of health systems in low-income and middle-income countries. It was published in january 2018 in BMJ Global Health. read more…

Donor-funded project’s sustainability assessment: a qualitative case study of a results-based financing pilot in Koulikoro region, Mali.

This study was just published in the Globalization and Health Journal. The authors, Mathieu Seppey, Valéry Ridde, Laurence Touré and Abdourahmane Coulibaly aimed to understand a pilot project’s sustainability process and to assess its level of sustainability. The project’s objective was to improve demand and supply of health services through financing performance.

read more…

Welcome to , research sharing site on public health interventions , particularly in a global health context.

Here you will find the scientific work and thoughts of Valery Ridde , his fellow researchers and students.


This collection of research documents deals with community-based health interventions in low-income countries and/or with issues concerning the more vulnerable populations in these countries and in Canada.