Mar 13, 2017 | equity of access to healthcare, research methodology
This article is set to be published on April 2017 in the Volume 61 of Evaluation and Program Planning and is already available online in open access. It was written by Anne Guichard, Émilie Tardieu, Christian Dagenais, Kareen Nour, Ginette Lafontaine and Valéry Ridde and it focuses on the combined use of concept mapping and focus groups to adapt a health equity tool in Canada. You can download the article hereunder. (more…)
Jul 21, 2016 | equity of access to healthcare
This article , published July 19, 2016 in Health Systems & Reform, and co- written by Christian Dagenais, Esther Mc Sween -Cadieux , Paul- André Somé and Valery Ridde presents some thoughts from the implementation and evaluation of a knowledge brokering program in Burkina Faso, as part of a research project on health equity in Burkina Faso. A link to the original article is available at the bottom of this page.
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Jun 29, 2016 | Uncategorized
This presentation on deliberative workshops as knowledge transfer tools was carried out by Christian Dagenais for a workshop being held as part of the Canadian Knowledge Mobilization Forum 2016 in Toronto. The presentation summarizes the reflections of Christian Dagenais, Esther Mc Sween-Cadieux and Valéry Ridde from holding several deliberative workshops as part of a research project on health equity in Burkina Faso. (more…)
Nov 21, 2014 | equity of access to healthcare, health policy analysis
An article published in BMC Public Health 2014 , november 7th 2014.
Authors: Nicole Atchessi, Valéry Ridde, Maria-Victoria Zunzunégui .
Abstract:
Background: In Burkina Faso, patients are required to pay for healthcare. This constitutes a barrier to access for indigents, who are the most disadvantaged. User fee exemption systems have been created to facilitate their access. A community-based initiative was thus implemented in a rural region of Burkina Faso to select the worst-off and exempt them from user fees. The final selection was not based on pre-defined criteria, but rather on community members’ tacit knowledge of the villagers. The objective of this study was to analyze the equitable nature of this community-based selection process.
Method: Based on a cross-sectional study carried out in 2010, we surveyed 1,687 indigents. The variables collected were those that determine healthcare use according to the Andersen-Newman model (1969): sociodemographic variables; income; occupation; access to financial, food or instrumental assistance; presence of chronic illness; and disabilities related to vision, muscle strength, or mobility. Bivariate analyses and logistic regression were performed.
Results: User fee exemptions were given mainly to indigents who were widowed (OR = 1.40; CI 95% [1.10–1.78]), had no financial assistance from their household for healthcare (OR = 1.58; CI 95% [1.26–1.97], lived alone (OR = 1.28; CI 95% [1.01–1.63]), lived with their spouses, (OR = 2.00; CI 95% [1.35-2.96], had vision impairments (OR = 1.45; CI 95% [1.14–1.84]), or had poor muscle strength and good mobility (OR = 1.73; CI 95% [1.28–2.33]). The indigent selection was not determined by household income, self-reported chronic illness, or previous use of services.
Conclusion: The community selection process took into account factors related to social vulnerability and functional limitations. However, we cannot affirm that the selection process was perfectly equitable, as it was very restrictive due to the limited budget available and the State’s lack of engagement in this matter. Exemption processes should be temporary solutions, and the State should make a commitment to move toward universal healthcare coverage.
Full article:
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Nicole Atchessi, Valéry Ridde, Maria-Victoria Zunzunégui. (2014). Is the process for selecting indigents to receive free care in Burkina Faso equitable?
BMC Public Health 2014.
https://doi.org/10.1186/1471-2458-14-1158
Nov 4, 2014 | equity of access to healthcare, health policy analysis
An article published in the issue n°9 of Implementation science, october 12th 2014.
Authors: Valéry Ridde, Anne-Marie Turcotte-Tremblay, Aurélia Souares, Julia Lohmann, David Zombré, Jean Louis Koulidiati, Maurice Yaogo, Hervé Hien, Matthew Hunt, Sylvie Zongo, Manuela De Allegri.
Abstract:
Background: The low quality of healthcare and the presence of user fees in Burkina Faso contribute to low utilization of healthcare and elevated levels of mortality. To improve access to high-quality healthcare and equity, national authorities are testing different intervention arms that combine performance-based financing with community-based health insurance and pro-poor targeting. There is a need to evaluate the implementation of these unique approaches. We developed a research protocol to analyze the conditions that led to the emergence of these intervention arms, the fidelity between the activities initially planned and those conducted, the implementation and adaptation processes, the sustainability of the interventions, the possibilities for scaling them up, and their ethical implications.
Methods/Design: The study adopts a longitudinal multiple case study design with several embedded levels of analyses. To represent the diversity of contexts where the intervention arms are carried out, we will select three districts. Within districts, we will select both primary healthcare centers (n =18) representing different intervention arms and the district or regional hospital (n =3). We will select contrasted cases in relation to their initial performance (good, fair, poor). Over a period of 18 months, we will use quantitative and qualitative data collection and analytical tools to study these cases including in-depth interviews, participatory observation, research diaries, and questionnaires. We will give more weight to qualitative methods compared to quantitative methods.
Discussion: Performance-based financing is expanding rapidly across low- and middle-income countries. The results of this study will enable researchers and decision makers to gain a better understanding of the factors that can influence the implementation and the sustainability of complex interventions aiming to increase healthcare quality as well as equity.
Full article:
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Valéry Ridde, Anne-Marie Turcotte-Tremblay, Aurélia Souares, Julia Lohmann, David Zombré, Jean Louis Koulidiati, Maurice Yaogo, Hervé Hien, Matthew Hunt, Sylvie Zongo, Manuela De Allegri. (2014). Protocol for the process evaluation of interventions combining performance-based financing with health equity in Burkina Faso.
Implementation Science,
9.
https://doi.org/10.1186/s13012-014-0149-1 Download
