@article{fdi:010092908,
  title = {{C}omprehensive assessment of the impact of mandatory community-based health insurance in {B}urkina {F}aso},
  author = {{B}outin, {D}. and {P}etitfour, {L}. and {A}llard, {Y}. and {K}ountoubr{\'e}, {S}. and {R}idde, {V}al{\'e}ry},
  editor = {},
  language = {{ENG}},
  abstract = {{H}ealth coverage for informal workers in {S}ub-{S}aharan {A}frica remains a major challenge. {T}his study evaluates an alternative approach: bundling health insurance with microcredit. {W}e conducted a randomized controlled trial in {O}uagadougou, {B}urkina {F}aso, to assess the impact of mandatory health insurance linked to microcredit. {T}he study covered 88 microcredit groups (44 treated, 44 control), analyzing outcomes for 1,095 individuals who reported illness episodes in the six months preceding the final survey in {J}anuary-{F}ebruary 2022. {R}esults show that the insurance requirement did not lead to program dropout, with loan renewal rates remaining stable between groups. {H}ealth insurance had a significant positive impact on financial protection: out-of-pocket expenses decreased by over 50% and payment difficulties by 36%. {T}he study also reveals changes in health-seeking behaviors. {U}se of modern healthcare facilities increased by 7%, while reliance on traditional medicine decreased by 61%. {I}nsured individuals also sought care more quickly, with 23% more seeking care on the same day symptoms appeared. {H}owever, no significant impact was observed on physical or psychological health outcomes. {T}hese findings suggest that bundling health insurance with other services like microcredit can be a viable solution for deploying mandatory health coverage to populations working in the informal sector. {T}his approach provides significant financial protection against health risks and improves access to healthcare.},
  keywords = {{H}ealth insurance ; {F}inancial protection ; {H}ealthcare utilization ; {I}nformal sector ; {B}urkina {F}aso ; {BURKINA} {FASO}},
  booktitle = {},
  journal = {{S}ocial {S}cience and {M}edicine},
  volume = {371},
  numero = {},
  pages = {117870 [17 p.]},
  ISSN = {0277-9536},
  year = {2025},
  DOI = {10.1016/j.socscimed.2025.117870},
  URL = {https://www.documentation.ird.fr/hor/fdi:010092908},
}