@article{fdi:010083822,
  title = {{D}oes the implementation of {UHC} reforms foster greater equality in health spending ? {E}vidence from a benefit incidence analysis in {B}urkina {F}aso},
  author = {{D}e {A}llegri, {M}. and {R}udasingwa, {M}. and {Y}eboah, {E}. and {B}onnet, {E}mmanuel and {S}ome, {P}. {A}. and {R}idde, {V}al{\'e}ry},
  editor = {},
  language = {{ENG}},
  abstract = {{I}ntroduction {B}urkina {F}aso is one among many countries in sub-{S}aharan {A}frica having invested in {U}niversal {H}ealth {C}overage ({UHC}) policies, with a number of studies have evaluated their impacts and equity impacts. {S}till, no evidence exists on how the distributional incidence of health spending has changed in relation to their implementation. {O}ur study assesses changes in the distributional incidence of public and overall health spending in {B}urkina {F}aso in relation to the implementation of {UHC} policies. {M}ethods {W}e combined {N}ational {H}ealth {A}ccounts data and household survey data to conduct a series of {B}enefit {I}ncidence {A}nalyses. {W}e captured the distribution of public and overall health spending at three time points. {W}e conducted separate analyses for maternal and curative services and estimated the distribution of health spending separately for different care levels. {R}esults {I}nequalities in the distribution of both public and overall spending decreased significantly over time, following the implementation of {UHC} policies. {P}ooling data on curative services across all care levels, the concentration index ({CI}) for public spending decreased from 0.119 ({SE} 0.013) in 2009 to -0.024 ({SE} 0.014) in 2017, while the {CI} for overall spending decreased from 0.222 ({SE} 0.032) in 2009 to 0.105 ({SE} 0.025) in 2017. {P}ooling data on institutional deliveries across all care levels, the {CI} for public spending decreased from 0.199 ({SE} 0.029) in 2003 to 0.013 ({SE} 0.002) in 2017, while the {CI} for overall spending decreased from 0.242 ({SE} 0.032) in 2003 to 0.062 ({SE} 0.016) in 2017. {P}ersistent inequalities were greater at higher care levels for both curative and institutional delivery services. {C}onclusion {O}ur findings suggest that the implementation of {UHC} in {B}urkina {F}aso has favoured a more equitable distribution of health spending. {N}onetheless, additional action is urgently needed to overcome remaining barriers to access, especially among the very poor, further enhancing equality.},
  keywords = {maternal health ; health economics ; health services research ; health systems ; {BURKINA} {FASO} ; {AFRIQUE} {SUBSAHARIENNE}},
  booktitle = {},
  journal = {{BMJ} {G}lobal {H}ealth},
  volume = {6},
  numero = {12},
  pages = {e005810 [11 ]},
  ISSN = {2059-7908},
  year = {2021},
  DOI = {10.1136/bmjgh-2021-005810},
  URL = {https://www.documentation.ird.fr/hor/fdi:010083822},
}