By: Valéry Ridde, Associate Professor, Department of Social and Preventive Medicine, School of Public Health, University of Montreal
Une politique de santé et ses contradictions. La gratuité des soins au Burkina Faso, au Mali, et au Niger (only in French) (more…)
An article of Thomas Druetz, Valéry Ridde, Seni Kouanda, Antarou Ly, Souleymane Diabaté and Slim Haddad published in Malaria Journal on february 13, 2015.
Abstract:
Background: Malaria is holo-endemic in Burkina Faso and causes approximately 40,000 deaths every year. In 2010, health authorities scaled up community case management of malaria with artemisinin-based combination therapy. Previous trials and pilot project evaluations have shown that this strategy may be feasible, acceptable, and effective under controlled implementation conditions. However, little is known about its effectiveness or feasibility/acceptability under real-world conditions of implementation at national scale. (more…)
Article by María José Arauz, Valéry Ridde, Libia Milena Hernández, Yaneth Charris, Mabel Carabali & Luis Ángel Villar published February 6, 2015 in PLoS ONE 10(2).
Abstract:
Background: Dengue fever is a public health problem in the tropical and sub-tropical world. Dengue cases have grown dramatically in recent years as well as dengue mortality. Colombia has experienced periodic dengue outbreaks with numerous dengue related-deaths, where the Santander department has been particularly affected. Although social determinants of health (SDH) shape health outcomes, including mortality, it is not yet understood how these affect dengue mortality. The aim of this pilot study was to develop and pre-test a social autopsy (SA) tool for dengue mortality.
Methods and Findings: The tool was developed and pre-tested in three steps. First, dengue fatal cases and ‘near misses’ (those who recovered from dengue complications) definitions were elaborated. Second, a conceptual framework on determinants of dengue mortality was developed to guide the construction of the tool. Lastly, the tool was designed and pre-tested among three relatives of fatal cases and six near misses in 2013 in the metropolitan zone of Bucaramanga. The tool turned out to be practical in the context of dengue mortality in Colombia after some modifications. The tool aims to study the social, individual, and health systems determinants of dengue mortality. The tool is focused on studying the socioeconomic position and the intermediary SDH rather than the socioeconomic and political context.
Conclusions: The SA tool is based on the scientific literature, a validated conceptual framework, researchers’ and health professionals’ expertise, and a pilot study. It is the first time that a SA tool has been created for the dengue mortality context. Our work furthers the study on SDH and how these are applied to neglected tropical diseases, like dengue. This tool could be integrated in surveillance systems to provide complementary information on the modifiable and avoidable death-related factors and therefore, be able to formulate interventions for dengue mortality reduction.
The project Access to healthcare for vulnerable groups in West Africa with the Help NGO produces extensions publications in order to make research results and knowledge more accessible.
“Having worked for the past 10 years on producing and applying scientific knowledge about healthcare access and financing in West Africa, we’d like to share a few observations that may sometimes be surprising, by experimenting with using satirical cartoons as a knowledge sharing tool.”
Ludovic Queuille & Valéry Ridde
Drawings in open access by Damien Glez. Enjoy… and shar it !
Two years ago on 12 December, the UN unanimously endorsed a resolution urging governments to ensure all people have access to quality health care without financial hardship.
On 12 December 2014, a global coalition is calling for universal health coverage to be a cornerstone of the sustainable development agenda and a priority
Join with us and 500+ organizations around the world to launch the first-ever Universal Health Coverage Day on 12 December 2014. This historic coalition will mark the anniversary of a landmark UN resolution urging all countries to provide universal access to health care without financial hardship.
No one should fall into poverty because they get sick and need health care. Universal health coverage is essential for making progress against challenges like HIV, cancer and Ebola – and for creating a fairer, more resilient society.
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: