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Economic evaluation of user fee removal/reduction policies for maternal care in Burkina Faso

Principal investigator: PD Dr. Manuela De Allegri, IPH Heidelberg

Prof. Valery Ridde, School of Public Health, Université of Montréal, Canada
Dr. Aleksandra Torbica, Assistant Professor, CERGAS, Bocconi University, Italy   

Project description:
In recent years, in an attempt to curb maternal and neonatal mortality through increased health service utilization, a number of African countries have removed or drastically reduced user fees for maternal care services. These policies have been the object of vast research. Still, existing studies have focused either on assessing the impact on health service utilization, related household out-of-pocket expenditure, and quality of care or on exploring implementation processes and possible policy gaps. To the present day, no efforts have been channeled towards conducting an economic evaluation, i.e. towards understanding the value for money related to the implementation of these policies.

Our study aims to fill this gap in knowledge by conducting an economic evaluation of the national user fee reduction policy and the user fee removal pilot implemented in Burkina Faso, starting in January 2007. We will adopt a societal perspective and value all direct medical costs, whether incurred by the health system or by households themselves. Based on a review of the literature complemented by expert opinions, we will use a decision-tree to model the effect of two alternative policies (user fee reduction and user fee removal) on both maternal and neonatal health outcomes. Costing information will be obtained from existing costing sources and complemented with information from an ad hoc micro-costing study conducted in four districts in the country.

We expect to disseminate preliminary findings by the end of 2017, both to the scientific and the policy community.

Status: ongoing

Contact: Manuela De Allegri (manuela.de.allegri@urz.uni-heidelberg.de)