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    Jan 15, 2021
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    Financial access to health care in Karuzi, Burundi: a household-survey based performance evaluation.

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    Authors
    Lambert-Evans, Sophie
    Ponsar, Frederique
    Reid, Tony
    Bachy, Catherine
    Van Herp, Michel
    Philips, Mit
    Affiliation
    Médecins Sans Frontières (Belgium), 94 rue Dupré, Brussels, Belgium. sophielambertevans@gmail.com.
    Issue Date
    2009-10-24
    
    Metadata
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    Journal
    International Journal for Equity in Health
    Abstract
    ABSTRACT: BACKGROUND: In 2003, Médecins Sans Frontières, the provincial government, and the provincial health authority began a community project to guarantee financial access to primary health care in Karuzi province, Burundi. The project used a community-based assessment to provide exemption cards for indigent households and a reduced flat fee for consultations for all other households. METHODS: An evaluation was carried out in 2005 to assess the impact of this project. Primary data collection was through a cross-sectional household survey of the catchment areas of 10 public health centres. A questionnaire was used to determine the accuracy of the community-identification method, households' access to health care, and costs of care. Household socioeconomic status was determined by reported expenditures and access to land. RESULTS: Financial access to care at the nearest health centre was ensured for 70% of the population. Of the remaining 30%, half experienced financial barriers to access and the other half chose alternative sites of care. The community-based assessment increased the number of people of the population who qualified for fee exemptions to 8.6% but many people who met the indigent criteria did not receive a card. Eighty-eight percent of the population lived under the poverty threshold. Referring to the last sickness episode, 87% of households reported having no money available and 25% risked further impoverishment because of healthcare costs even with the financial support system in place. CONCLUSION: The flat fee policy was found to reduce cost barriers for some households but, given the generalized poverty in the area, the fee still posed a significant financial burden. This report showed the limits of a programme of fee exemption for indigent households and a flat fee for others in a context of widespread poverty.
    URI
    http://hdl.handle.net/10144/88051
    DOI
    10.1186/1475-9276-8-36
    PubMed ID
    19852830
    Language
    en
    ISSN
    1475-9276
    ae974a485f413a2113503eed53cd6c53
    10.1186/1475-9276-8-36
    Scopus Count
    Collections
    Health Politics

    entitlement

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