This article written by Valéry Ridde, Lucie Lechat and Ivlabehire Bertrand Meda was published on the BMJ Global Health Journal on July 7th 2016. The article is about the resilience of the Burkina Faso’s health system following the terrorist attack of January 15th 2016 in Ouagadougou. The article is published in open acces and is available to download under its abstract.



In Africa, health systems are often not very responsive. Their resilience is often tested by health or geopolitical crises. The Ebola epidemic, for instance, exposed the fragility of health systems, and recent terrorist attacks have required countries to respond to urgent situations. Up until 2014, Burkina Faso’s health system strongly resisted these pressures and reforms had always been minor. However, since late 2014, Burkina Faso has had to contend with several unprecedented crises. In October 2014, there was a popular insurrection. Then, in September 2015, the Security Regiment of the deposed president attempted a coup d’état. Finally, on 15 January 2016, a terrorist attack occurred in the capital, Ouagadougou. These events involved significant human injury and casualties. In these crises, the Burkinabè health system was sorely tried, testing its responsiveness, resiliency and adaptability. We describe the management of the recent terrorist attack from the standpoint of health system resilience. It would appear that the multiple crises that had occurred within the previous 2 years led to appropriate management of that terrorist attack thanks to the rapid mobilisation of personnel and good communication between centres. For example, the health system had put in place a committee and an emergency response plan, adapted blood bank services and psychology services, and made healthcare free for victims. Nevertheless, the system encountered several challenges, including the development of framework documents for resources (financial, material and human) and their use and coordination in crisis situations.

Key questions:

What is already known about this topic?

  • The concept of health system resilience is still new.

  • Health systems in West Africa are precarious, not very responsive, and dysfunctional.

  • Terrorist attacks in Africa are increasing and pose challenges for health systems.

What are the new findings?

  • Burkina Faso’s health system has always made marginal changes, without major reforms.

  • The series of political and terrorist events since 2014 have prompted the actors to adapt.

  • The continuity of medical and psychological services provided, and their continued provision free of charge, should be monitored.

Recommendations for policy

  • A crisis response plan should be formulated and put in place.

  • Health personnel should be better trained to manage crises.

  • Healthcare facilities need to be better prepared.


Download and suggested citation:

Ridde, V., Lechat, L., & Meda, I. B. (2016). Terrorist attack of 15 January 2016 in Ouagadougou: how resilient was Burkina Faso’s health system? BMJ Global Health. Download