Nguyen H. T., Torbica A., Brenner S., Kiendrebeogo J. A., Tapsoba L., Ridde Valéry, De Allegri M. (2020). Economic evaluation of user-fee exemption policies for maternal healthcare in Burkina Faso : evidence from a cost-effectiveness analysis. Value in Health, 23 (3), 300-308. ISSN 1098-3015.
Titre du document
Economic evaluation of user-fee exemption policies for maternal healthcare in Burkina Faso : evidence from a cost-effectiveness analysis
Nguyen H. T., Torbica A., Brenner S., Kiendrebeogo J. A., Tapsoba L., Ridde Valéry, De Allegri M.
Source
Value in Health, 2020,
23 (3), 300-308 ISSN 1098-3015
Objectives: The reduction and removal of user fees for essential care services have recently become a key instrument to advance universal health coverage in sub-Saharan Africa, but no evidence exists on its cost-effectiveness. We aimed to address this gap by estimating the cost-effectiveness of 2 user-fee exemption inte rventions in Burkina Faso between 2007 and 2015: the national 80% user-fee reduction policy for delivery care services and the user-fee removal pilot (ie, the complete [100%] user-fee removal for delivery care) in the Sahel region. Methods: We built a single decision tree to evaluate the cost-effectiveness of the 2 study interventions and the baseline. The decision tree was populated with an own impact evaluation and the best available epidemiological evidence. Results: Relative to the baseline, both the national 80% user-fee reduction policy and the user-fee removal pilot are highly cost-effective, with incremental cost-effectiveness ratios of 210.22 and 252.51 per disability-adjusted life-year averted, respectively. Relative to the national 80% user-fee reduction policy, the user-fee removal pilot entails an incremental cost-effectiveness ratio of 309.74 per disability-adjusted life-year averted. Conclusions: Our study suggests that it is worthwhile for Burkina Faso to move from an 80% reduction to the complete removal of user fees for delivery care. Local analyses should be done to identify whether it is worthwhile to implement user-fee exemptions in other sub-Saharan African countries.
Plan de classement
Santé : aspects socioculturels, économiques et politiques [056]
