@article{fdi:010074417,
  title = {{I}mpact of fee subsidy policy on perinatal health in a low-resource setting : a quasi-experimental study},
  author = {{M}eda, {I}. {B}. and {D}umont, {A}lexandre and {K}ouanda, {S}. and {R}idde, {V}al{\'e}ry},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {A} national subsidy policy was introduced in 2007 in {B}urkina {F}aso to improve financial accessibility to facility-based delivery. {I}n this article, we estimated the effects of reducing user fees on institutional delivery and neonatal mortality, immediately and three years after the introduction of the policy. {M}ethods {T}he study was based on a quasi-experimental design. {W}e used data obtained from the 2010 {D}emographic and {H}ealth {S}urvey, including survival information for 32,102 live-born infants born to 12,474 women. {W}e used a multilevel {P}oisson regression model with robust variances to control for secular trends in outcomes between the period before the introduction of the policy (1 {J}anuary, 2007) and the period after. {I}n sensitivity analyses, we used two different models according to the different definitions of the period "before" and the period "after". {R}esults {I}mmediately following its introduction, the subsidy policy was associated with increases in institutional deliveries by 4% ({RR} = 1.04, 95% {CI}: 0.98-1.10) in urban areas and by 12% ({RR} = 1.12, 95% {CI}: 1.04-1.20) in rural areas. {T}he results showed similar patterns in sensitivity analyses. {T}his effect was particularly marked among rural clusters with low institutional delivery rates at baseline ({RR} = 1.44, 95% {CI}: 1.33-1.55). {I}t was persistent for 42 months after the introduction of the policy but these increases were not statistically significant. {A}t 42 months, the delivery rates had increased by 26% in rural areas ({RR} = 1.26; 95% {CI}: 0.86-1.86) and 13% ({RR} = 1.13; 95% {CI}: 0.88-1.46) in urban areas. {T}here was no evidence of a significant decrease in neonatal mortality rates. {C}onclusion {T}he delivery subsidy implemented in {B}urkina {F}aso is associated with short-term increases in health facility deliveries. {T}his policy has been particularly beneficial for rural households.},
  keywords = {{BURKINA} {FASO}},
  booktitle = {},
  journal = {{PL}o{S} {O}ne},
  volume = {13},
  numero = {11},
  pages = {e0206978 [ 15 ]},
  ISSN = {1932-6203},
  year = {2018},
  DOI = {10.1371/journal.pone.0206978},
  URL = {https://www.documentation.ird.fr/hor/fdi:010074417},
}