Free healthcare for some, fee-paying for the rest: adaptive practices and ethical issues in rural communities in the district of Boulsa, Burkina Faso
In Burkina Faso, in July 2016, user fees were removed at all public healthcare facilities, but only for children under 60 months of age and for “mothers”, i.e. for reproductive care. This study was conducted in five rural communities in Boulsa District (Burkina Faso) (1) to understand the perception...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-01-01
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| Series: | Global Bioethics |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/11287462.2021.1966974 |
| _version_ | 1798024885511913472 |
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| author | Thomas Druetz Alice Bila Frank Bicaba Cheick Tiendrebeogo Abel Bicaba |
| author_facet | Thomas Druetz Alice Bila Frank Bicaba Cheick Tiendrebeogo Abel Bicaba |
| author_sort | Thomas Druetz |
| collection | DOAJ |
| description | In Burkina Faso, in July 2016, user fees were removed at all public healthcare facilities, but only for children under 60 months of age and for “mothers”, i.e. for reproductive care. This study was conducted in five rural communities in Boulsa District (Burkina Faso) (1) to understand the perceptions and practices of stakeholders regarding compliance with eligibility criteria for free care and (2) to explore the ethical tensions that may have resulted from this policy. Semi-directed individual interviews (n = 20) were conducted with healthcare personnel and mothers of young children. Interviews were recorded and transcribed, and a thematic content analysis was conducted. The study reveals the presence of practices to circumvent strict compliance with the eligibility criteria for free access. These include hiding the exact age of children over 60 months and using eligible persons for the benefit of others. These practices result from ethical and economic tensions experienced by the beneficiaries. They also raise dilemmas among healthcare providers, who have to enforce compliance with the eligibility criteria while realizing the households’ deprivation. Informal adjustments are introduced at the community level to reconcile the healthcare providers’ dissonance. Local reinvention mechanisms help in overcoming ethical tensions and in implementing the policy. |
| first_indexed | 2024-04-11T18:09:49Z |
| format | Article |
| id | doaj.art-850d3a1899374d03be04deb655c94f66 |
| institution | Directory Open Access Journal |
| issn | 1128-7462 1591-7398 |
| language | English |
| last_indexed | 2024-04-11T18:09:49Z |
| publishDate | 2021-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Bioethics |
| spelling | doaj.art-850d3a1899374d03be04deb655c94f662022-12-22T04:10:10ZengTaylor & Francis GroupGlobal Bioethics1128-74621591-73982021-01-0132110011510.1080/11287462.2021.19669741966974Free healthcare for some, fee-paying for the rest: adaptive practices and ethical issues in rural communities in the district of Boulsa, Burkina FasoThomas Druetz0Alice Bila1Frank Bicaba2Cheick Tiendrebeogo3Abel Bicaba4School of Public HealthSociété d’Études et de Recherche en Santé Publique (SERSAP)Société d’Études et de Recherche en Santé Publique (SERSAP)School of Public HealthSociété d’Études et de Recherche en Santé Publique (SERSAP)In Burkina Faso, in July 2016, user fees were removed at all public healthcare facilities, but only for children under 60 months of age and for “mothers”, i.e. for reproductive care. This study was conducted in five rural communities in Boulsa District (Burkina Faso) (1) to understand the perceptions and practices of stakeholders regarding compliance with eligibility criteria for free care and (2) to explore the ethical tensions that may have resulted from this policy. Semi-directed individual interviews (n = 20) were conducted with healthcare personnel and mothers of young children. Interviews were recorded and transcribed, and a thematic content analysis was conducted. The study reveals the presence of practices to circumvent strict compliance with the eligibility criteria for free access. These include hiding the exact age of children over 60 months and using eligible persons for the benefit of others. These practices result from ethical and economic tensions experienced by the beneficiaries. They also raise dilemmas among healthcare providers, who have to enforce compliance with the eligibility criteria while realizing the households’ deprivation. Informal adjustments are introduced at the community level to reconcile the healthcare providers’ dissonance. Local reinvention mechanisms help in overcoming ethical tensions and in implementing the policy.http://dx.doi.org/10.1080/11287462.2021.1966974free healthcareuser fee abolitionethical issuesincapacity to paydeontological dilemmaburkina faso |
| spellingShingle | Thomas Druetz Alice Bila Frank Bicaba Cheick Tiendrebeogo Abel Bicaba Free healthcare for some, fee-paying for the rest: adaptive practices and ethical issues in rural communities in the district of Boulsa, Burkina Faso Global Bioethics free healthcare user fee abolition ethical issues incapacity to pay deontological dilemma burkina faso |
| title | Free healthcare for some, fee-paying for the rest: adaptive practices and ethical issues in rural communities in the district of Boulsa, Burkina Faso |
| title_full | Free healthcare for some, fee-paying for the rest: adaptive practices and ethical issues in rural communities in the district of Boulsa, Burkina Faso |
| title_fullStr | Free healthcare for some, fee-paying for the rest: adaptive practices and ethical issues in rural communities in the district of Boulsa, Burkina Faso |
| title_full_unstemmed | Free healthcare for some, fee-paying for the rest: adaptive practices and ethical issues in rural communities in the district of Boulsa, Burkina Faso |
| title_short | Free healthcare for some, fee-paying for the rest: adaptive practices and ethical issues in rural communities in the district of Boulsa, Burkina Faso |
| title_sort | free healthcare for some fee paying for the rest adaptive practices and ethical issues in rural communities in the district of boulsa burkina faso |
| topic | free healthcare user fee abolition ethical issues incapacity to pay deontological dilemma burkina faso |
| url | http://dx.doi.org/10.1080/11287462.2021.1966974 |
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