dc.contributor |
Médecins Sans Frontières (Belgium), 94 rue Dupré, Brussels, Belgium. sophielambertevans@gmail.com. |
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dc.creator |
Lambert-Evans, Sophie |
|
dc.creator |
Ponsar, Frederique |
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dc.creator |
Reid, Tony |
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dc.creator |
Bachy, Catherine |
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dc.creator |
Van Herp, Michel |
|
dc.creator |
Philips, Mit |
|
dc.date |
2009-10-24 |
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dc.date.accessioned |
2017-01-31T07:15:33Z |
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dc.date.available |
2017-01-31T07:15:33Z |
|
dc.identifier |
Financial access to health care in Karuzi, Burundi: a household-survey based performance evaluation. 2009, 8:36 Int J Equity Health |
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dc.identifier |
1475-9276 |
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dc.identifier |
19852830 |
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dc.identifier |
10.1186/1475-9276-8-36 |
|
dc.identifier |
http://hdl.handle.net/10144/88051 |
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dc.identifier |
http://fieldresearch.msf.org/msf/handle/10144/88051 |
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dc.identifier |
International Journal for Equity in Health |
|
dc.identifier.uri |
http://dspace.mediu.edu.my:8181/xmlui/handle/10144/88051 |
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dc.description |
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. |
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dc.language |
en |
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dc.rights |
Archived with thanks to International Journal for Equity in Health |
|
dc.title |
Financial access to health care in Karuzi, Burundi: a household-survey based performance evaluation. |
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