1
|
Sia D, Dondbzanga BDG, Carabali M, Bonnet E, Enok Bonong PR, Ridde V. Effect of a free healthcare policy on health services utilisation for non-malarial febrile illness by children under five years in Burkina Faso: an interrupted time series analysis. Trop Med Int Health 2020; 25:1226-1234. [PMID: 32686252 DOI: 10.1111/tmi.13468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the effect of a free healthcare policy for children under five years old implemented in Burkina Faso since April 2016, on the use of health care of non-malarial febrile illnesses (NMFI). METHODS To assess the immediate and long-term effect of the free healthcare policy in place, we conducted an interrupted time series analysis of routinely collected data on febrile illnesses from three urban primary health centres of Ouagadougou between 1 January 2015 and 31 December 2016. RESULTS Of the 39 046 febrile cases reported in the study period, 17 017 NMFI were included in the study. Compared to the period before the intervention, we observed an immediate, non-statistically significant increase of 7% in the number of NMFI (IRR = 1.07; 95% CI = 0.75, 1.51). Compared to the trend that would have been expected in absence of the intervention, the results showed a small but sustained increase of 6% in the trend of monthly number of NMFI during the intervention period (IRR = 1.06; 95%CI = 1.01, 1.12). CONCLUSION Our study highlighted an increase in the uptake of healthcare services, specifically for NMFI by children under five years of age, after the implementation of a free care policy. This analysis contributes to informing decision makers on the need to strengthen the capacities of healthcare centres and to anticipate the challenges of the sustainability of this policy.
Collapse
Affiliation(s)
- D Sia
- University of Québec in Outaouais, Saint-Jérôme, QC, Canada
| | | | - M Carabali
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - E Bonnet
- IRD (French Institute for Research on Sustainable Development), UMI Résiliences, Bondy, France
| | - P R Enok Bonong
- Department of Médecine Préventive, University of Montréal, Montreal, Canada
| | - V Ridde
- IRD (French Institute for Research on Sustainable Development), UMI Résiliences, Bondy, France
| |
Collapse
|
2
|
Sana B, Kaboré A, Hien H, Zoungrana BE, Meda N. [Study considering the use of medicines in children receiving free care]. Pan Afr Med J 2019; 34:194. [PMID: 32180868 PMCID: PMC7061021 DOI: 10.11604/pamj.2019.34.194.19613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 09/05/2019] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Rational medical prescription is a concern for the health systems and policies of African countries. The purpose of this study was to analyze the use of medicines in children aged 0 to 5 years receiving free care. METHODS We conducted a cross-sectional study considering the use of medicines in 20 randomly selected health facilities level 1 in Ouagadougou. The reference of the World Health Organization and of the International Network for the Rational Use of Drugs (WHO/INRUD) was used to analyze data. Descriptive statistics were used as the average and standard deviation. Differences were measured using ANOVA test. RESULTS In total, 1.206 prescriptions were reviewed between April 2016 and March 2017. The number of medicines issued on prescription was 2.9, the percentage of generic medicines prescribed was 88.7% and 97.7% of medicines prescribed were registered on the National List of Essential Medicines. The percentage of consultations during which antibiotics were prescribed was 83.2%, and 9.3% of prescriptions contained at least one injectable product. CONCLUSION Irrational prescription is mainly relates to the use of antibiotics. Essential alertness should be given to the treatment of children less than 5 years to avoid an excessive consumption of medicines and the emergence of antibiotic resistance.
Collapse
Affiliation(s)
- Boukary Sana
- Direction Générale de l'Accès aux Produits de Santé, Ouagadougou, Burkina Faso
- Université Joseph Ki Zerbo, Département de Santé Publique, Ouagadougou, Burkina Faso
| | - Ahmed Kaboré
- Université Joseph Ki Zerbo, Département de Santé Publique, Ouagadougou, Burkina Faso
| | - Hervé Hien
- Institut National de Santé Publique, Ouagadougou, Burkina Faso
- Institut de Recherche en Science de la Santé, Bobo-Dioulasso, Burkina Faso
| | | | - Nicolas Meda
- Université Joseph Ki Zerbo, Département de Santé Publique, Ouagadougou, Burkina Faso
| |
Collapse
|
3
|
Singh D, Luz ACG, Rattanavipapong W, Teerawattananon Y. Designing the Free Drugs List in Nepal: A Balancing Act Between Technical Strengths and Policy Processes. MDM Policy Pract 2017; 2:2381468317691766. [PMID: 30288415 PMCID: PMC6125041 DOI: 10.1177/2381468317691766] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 01/05/2017] [Indexed: 11/30/2022] Open
Abstract
As more countries provide free health care, pharmaceutical reimbursement lists
are becoming a concern, especially in low- and middle-income countries. In 2007,
Nepal decreed that health is a human right and began basic health coverage for a
target group of the poor, destitute, elderly, and disabled. The Ministry of
Health and Population (MoHP) also provided 40 drugs without cost to all citizens
through the Free Drugs List (FDL) program. The FDL was later expanded from 40 to
70 drugs; however, the process of review and update remains unclear. To propose
a mechanism for future development of the FDL, we conducted a document review
and in-depth consultations with representatives from the MoHP and the World
Health Organization Country Office during a workshop in Kathmandu. The FDL
suffers from lack of an appropriate process, gaps between the listed drugs and
Nepal’s burden of disease, and no consideration of the unit costs or
cost-effectiveness of drugs included in the list. We propose a new drug
selection process that is a variant of the health technology assessment process.
This process can be applied not only in Nepal but also in other resource-limited
countries that wish to ensure their citizens’ access to essential medicines
through a pharmaceutical reimbursement list.
Collapse
Affiliation(s)
- Devika Singh
- Georgia Institute of Technology, Atlanta, Georgia (DS), Department of Health, Ministry of Public Health, Nonthaburi, Thailand.,Health Intervention and Technology Assessment Program International Unit (ACGL, WR), Department of Health, Ministry of Public Health, Nonthaburi, Thailand.,Health Intervention and Technology Assessment Program (YT), Department of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Alia Cynthia Gonzales Luz
- Georgia Institute of Technology, Atlanta, Georgia (DS), Department of Health, Ministry of Public Health, Nonthaburi, Thailand.,Health Intervention and Technology Assessment Program International Unit (ACGL, WR), Department of Health, Ministry of Public Health, Nonthaburi, Thailand.,Health Intervention and Technology Assessment Program (YT), Department of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Waranya Rattanavipapong
- Georgia Institute of Technology, Atlanta, Georgia (DS), Department of Health, Ministry of Public Health, Nonthaburi, Thailand.,Health Intervention and Technology Assessment Program International Unit (ACGL, WR), Department of Health, Ministry of Public Health, Nonthaburi, Thailand.,Health Intervention and Technology Assessment Program (YT), Department of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Yot Teerawattananon
- Georgia Institute of Technology, Atlanta, Georgia (DS), Department of Health, Ministry of Public Health, Nonthaburi, Thailand.,Health Intervention and Technology Assessment Program International Unit (ACGL, WR), Department of Health, Ministry of Public Health, Nonthaburi, Thailand.,Health Intervention and Technology Assessment Program (YT), Department of Health, Ministry of Public Health, Nonthaburi, Thailand
| |
Collapse
|
4
|
Basnet R, Shrestha BR, Nagaraja SB, Basnet B, Satyanarayana S, Zachariah R. Universal health coverage in a regional Nepali hospital: who is exempted from payment? Public Health Action 2013; 3:90-2. [PMID: 26393004 PMCID: PMC4463078 DOI: 10.5588/pha.12.0082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 01/29/2013] [Indexed: 11/10/2022] Open
Abstract
This study assessed the characteristics of beneficiaries of a government-led policy of exemption for payment being provided in a regional hospital in Nepal. In January and February 2012, 9547 patients sought services at the out-patient clinic, the majority (83%) of whom were from the same district although this was a referral hospital for 15 districts. Only 10.8% received exemption from payment; 66% of the individuals aged >60 years and eligible for exemption were missed. These shortcomings highlight intrinsic weaknesses in the current implementing mechanisms for payment exemption, which may not be providing financial protection. This hampers efforts towards achieving universal health coverage.
Collapse
Affiliation(s)
- R Basnet
- Nepal Health Sector Support Programme, Mid-Western Regional Health Directorate, Surkhet, Nepal
| | | | - S B Nagaraja
- Office of the World Health Organization Representative in India, New Delhi, India
| | - B Basnet
- Mid-Western Regional Hospital, Surkhet, Nepal
| | - S Satyanarayana
- International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office, Delhi, India
| | - R Zachariah
- Médecins Sans Frontières (MSF), Medical Department (Operational Research), MSF-Brussels Operational Centre, Luxembourg
| |
Collapse
|