Soutien à la recherche et concours Lauréats du concours "Appui à la rédaction de publications scientifiques traitant d'un thème relié aux politiques publiques et à la santé des populations" 2017-2018


Félicitations à David Zombre (UdeM) et collègues, lauréat du concours de soutien à la publication 2017-2018 lancé par le RS PPSP. Découvrez le résumé de son article "An evaluation of healthcare use and child morbidity four years after user fee removal in rural Burkina Faso".

Coauteurs: Valery Ridde et Kate Zinzser


Objectives: Increasing financial access to health care is postulated to be essential to improvingchild health outcomes, but available evidence on the actual link between increased access andhealth is still scarce. We evaluated the contextual effect of living in a setting where user fees wereremoved on the probability of an illness occurring and the likelihood of using health servicesamong children under five, and explored the potential effect on the inequality in access to care.

Methods: We used a comparative cross-sectional design exploiting data collected four years afterthe intervention onset in one intervention and one comparison district, and propensity scoresweighting to achieve balance on covariates between the 2 districts, and multilevel modelling toestimate average marginal effect (AME).

Results: We found no evidence that living in the intervention district was associated with areduced probability of an illness occurring (AME=4.4 [95% CI: -1.0 – 9.8]). However, comparedto children living in the comparison district, the probability of using health services was 17.2%higher among those living in intervention district [95% CI: 15.0, 26.6]; and 20.7% higher whenthe illness episode was severe [95% CI: 9.9; 31.5]. We detected no difference in the probability ofthe use of health services according to the SES [χ² (5) = 12.90, p=0.61].

Conclusions: UFR is relevant and necessary to increase the use of health services in the longterm,but it is not adequate by itself to reduce the probability of illness occurrence andsocioeconomic inequities in the use of health services.