@article{fdi:010086740,
  title = {{H}ow a supply-side intervention can help to increase caesarean section rates in {B}urkina {F}aso facilities : evidence from an interrupted time-series analysis using routine health data},
  author = {{R}avit, {M}. and {L}ohmann, {J}. and {D}umont, {A}lexandre and {K}abore, {C}. and {K}oulidiati, {J}. {L}. and {D}e {A}llegri, {M}.},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjectives: {I}n {B}urkina {F}aso, only 2.1% of women give birth by caesarean section ({CS}). {T}o improve the use of maternal health services during pregnancy and childbirth, many interventions were implemented during the 2010s including performance-based financing ({PBF}) and a free maternal health care policy (the gratuite). {T}he objective of this study is to evaluate the impact of a supply-side intervention ({PBF}) combined with a demand-side intervention (gratuite) on institutional {CS} rates in {B}urkina {F}aso.{M}ethods: {W}e used routine health data from all the public health facilities in 21 districts (10 that implemented {PBF} and 11 that did not) from {J}anuary 2013 to {S}eptember 2017. {W}e analysed {CS} rates as the proportion of {CS} performed out of all facility-based deliveries ({FBD}) that occurred in the district. {W}e performed an interrupted time series ({ITS}) analysis to evaluate the impact of {PBF} alone and then in conjunction with the gratuite on institutional {CS} rates.{R}esults: {CS} rates in {B}urkina {F}aso increased slightly between {J}anuary 2013 and {S}eptember 2017 in all districts. {A}fter the introduction of {PBF}, the increase of {CS} rates was higher in intervention than in non-intervention districts. {H}owever, after the introduction of the gratuite, {CS} rates decreased in all districts, independently of the {PBF} intervention.{C}onclusion: {I}n 2017, despite high {FBD} rates in {B}urkina {F}aso as well as the {PBF} intervention and the gratuite, less than 3% of women who gave birth in a health facility did so by {CS}. {O}ur study shows that the positive {PBF} effects were not sustained in a context of user fee exemption.},
  keywords = {{B}urkina {F}aso ; caesarean section ; health policy ; low-income countries ; maternal health ; performance-based financing ; user fees ; {BURKINA} {FASO}},
  booktitle = {},
  journal = {{T}ropical {M}edicine and {I}nternational {H}ealth},
  numero = {},
  pages = {[8 ]},
  ISSN = {1360-2276},
  year = {2023},
  DOI = {10.1111/tmi.13840},
  URL = {https://www.documentation.ird.fr/hor/fdi:010086740},
}