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

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dc.contributor Médecins Sans Frontières (Belgium), 94 rue Dupré, Brussels, Belgium. sophielambertevans@gmail.com.
dc.creator Lambert-Evans, Sophie
dc.creator Ponsar, Frederique
dc.creator Reid, Tony
dc.creator Bachy, Catherine
dc.creator Van Herp, Michel
dc.creator Philips, Mit
dc.date 2009-10-24
dc.date.accessioned 2017-01-31T07:15:33Z
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
dc.identifier 1475-9276
dc.identifier 19852830
dc.identifier 10.1186/1475-9276-8-36
dc.identifier http://hdl.handle.net/10144/88051
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/88051
dc.identifier International Journal for Equity in Health
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/88051
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.
dc.language en
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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