L’exemption de paiement des soins associée à la supervision et à la formation au Burkina Faso : les effets sur la prescription de médicaments
The limited financial access to health care has encouraged the creation of health policies for subsidizing care in Africa. In Burkina Faso, an NGO, in line with the national health policy has been subsidizing care and medicines for children under five years in the health district of Dori since September 2008. The program includes training of health workers, supervision and removal of fees for health care and medication. The aim of the study was to analyze the effect of this free care program on the adequacy of drugs prescriptions.  Nine health centers were taken into account. A total of 14,956 prescriptions of the target group of children under five years were collected from consultation records a year before and after the introduction of free care program. In addition, fourteen prescribers were interviewed. The prescriptions were analyzed in comparison to the WHO and the national reference. The prescribers’ responses were analyzed to understand their perception of their change in practice since the introduction of the free care program. The study showed that the free care program had an effect by decreasing the use of injections (Odds Ratio (OR) =0.28, p < 0.005) in acute respiratory infections (ARI) cases. It also led to decrease in inappropriate use of antibiotics in the case of malaria (OR=0.48, p<0.0005). The average number of drugs per prescription was also found to have decreased by 14% (p<0.0005) in ARI cases. Several prescribers asserted that their practices are maintained or improved. The program leads to an improvement in the adequacy of drugs prescriptions.
free care rational use of medicines essential medicines children under five years