Références bibliographiques

Mwase Takondwa, Brenner Stephan, Mazalale Jacob, Lohmann Julia, Hamadou Saidou, Somda Serge M. A., Ridde Valery et De Allegri Manuela (2018) « Inequities and their determinants in coverage of maternal health services in Burkina Faso », International Journal for Equity in Health, 17 (1). DOI : 10.1186/s12939-018-0770-8. https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-018-0770-8.

Résumé : Background Poor and marginalized segments of society often display the worst health status due to limited access to health enhancing interventions. It follows that in order to enhance the health status of entire populations, inequities in access to health care services need to be addressed as an inherent element of any effort targeting Universal Health Coverage. In line with this observation and the need to generate evidence on the equity status quo in sub-Saharan Africa, we assessed the magnitude of the inequities and their determinants in coverage of maternal health services in Burkina Faso. Methods We assessed coverage for three basic maternal care services (at least four antenatal care visits, facility-based delivery, and at least one postnatal care visit) using data from a cross-sectional household survey including a total of 6655 mostly rural, poor women who had completed a pregnancy in the 24 months prior to the survey date. We assessed equity along the dimensions of household wealth, distance to the health facility, and literacy using both simple comparative measures and concentration indices. We also ran hierarchical random effects regression to confirm the presence or absence of inequities due to household wealth, distance, and literacy, while controlling for potential confounders. Results Coverage of facility based delivery was high (89%), but suboptimal for at least four antenatal care visits (44%) and one postnatal care visit (53%). We detected inequities along the dimensions of household wealth, literacy and distance. Service coverage was higher among the least poor, those who were literate, and those living closer to a health facility. We detected a significant positive association between household wealth and all outcome variables, and a positive association between literacy and facility-based delivery. We detected a negative association between living farther away from the catchment facility and all outcome variables. Conclusion Existing inequities in maternal health services in Burkina Faso are likely going to jeopardize the achievement of Universal Health Coverage. It is important that policy makers continue to strengthen and monitor the implementation of strategies that promote proportionate universalism and forge multi-sectoral approach in dealing with social determinants of inequities in maternal health services coverage.

Nguyen Hoa Thi, Zombré David, Ridde Valery et De Allegri Manuela (2018) « The impact of reducing and eliminating user fees on facility-based delivery: a controlled interrupted time series in Burkina Faso », Health Policy and Planning, septembre 2018 (septembre 26). DOI : 10.1093/heapol/czy077. https://academic.oup.com/heapol/advance-article/doi/10.1093/heapol/czy077/5107204.

Résumé : User fee reduction and removal policies have been the object of extensive research, but little rigorous evidence exists on their sustained effects in relation to use of delivery care services, and no evidence exists on the effects of partial reduction compared with full removal of user fees. We aimed to fill these knowledge gaps by assessing sustained effects of both partial reduction and complete removal of user fees on utilization of facility-based delivery. Our study took place in four districts in the Sahel region of Burkina Faso, where the national user fee reduction policy (SONU) launched in 2007 (lowering fees at point of use by 80%) co-existed with a user fee removal pilot launched in 2008. We used Health Management Information System data to construct a controlled interrupted time-series analysis and examine both immediate and sustained effects of SONU and the pilot from January 2004 to December 2014. We found that both SONU and the pilot led to a sustained increase in the use of facility-based delivery. SONU produced an accumulative increase of 31.4% (P < 0.01) over 8 years in the four study districts. The pilot further enhanced utilization and produced an additional increase of 23.2% (P < 0.001) over 6 years. These increasing trends did not continue to reach full coverage, i.e. ensuring that all women had a facility-based delivery. Instead, they stabilized 3 years and 4 years after the onset of SONU and the pilot, respectively. Our study provides further evidence that user fee reduction and removal policies are effective in increasing service use in the long term. However, they alone are not sufficient to achieve full coverage. This calls for the need to implement additional measures, targeting for instance geographical barriers and knowledge gaps, to achieve the target of all women delivering in the presence of a skilled attendant.

Olivier de Sardan Jean-Pierre Olivier et Ridde Valery (2018) « Réponse au texte « Gratuité des soins ? Ce qu’il faudrait prouver… » de Joseph Brunet-Jailly », Afrique contemporaine, 265 (1), p. 141. DOI : 10.3917/afco.265.0141. http://www.cairn.info/revue-afrique-contemporaine-2018-1-page-141.htm.

Résumé : Joseph Brunet-Jailly développe longuement deux mises en cause radicales de notre posture générale, qui sont à notre avis totalement infondées, soit parce qu’elles nous font dire le contraire de ce que nous disons, soit parce qu’il se trompe quant aux questions méthodologiques. D’autre part, il critique toute une série de points particuliers de l’ouvrage, en faisant de nombreux contresens sur nos propos, en ignorant nos arguments ou en méconnaissant la littérature scientifique sur le sujet.

Osorio Lyda, Garcia Jonny Alejandro, Parra Luis Gabriel, Garcia Victor, Torres Laura, Degroote Stéphanie et Ridde Valéry (2018) « A scoping review on the field validation and implementation of rapid diagnostic tests for vector-borne and other infectious diseases of poverty in urban areas », Infectious Diseases of Poverty, 7 (87) (décembre), p. 1-18. DOI : 10.1186/s40249-018-0474-8. https://idpjournal.biomedcentral.com/articles/10.1186/s40249-018-0474-8.

Résumé : Background: Health personnel face challenges in diagnosing vector-borne and other diseases of poverty in urban settings. There is a need to know what rapid diagnostic technologies are available, have been properly assessed, and are being implemented to improve control of these diseases in the urban context. This paper characterizes evidence on the field validation and implementation in urban areas of rapid diagnostics for vector-borne diseases and other diseases of poverty. Main body: A scoping review was conducted. Peer-reviewed and grey literature were searched using terms describing the targeted infectious diseases, diagnostics evaluations, rapid tests, and urban setting. The review was limited to studies published between 2000 and 2016 in English, Spanish, French, and Portuguese. Inclusion and exclusion criteria were refined post hoc to identify relevant literature regardless of study design and geography. A total of 179 documents of the 7806 initially screened were included in the analysis. Malaria (n = 100) and tuberculosis (n = 47) accounted for the majority of studies that reported diagnostics performance, impact, and implementation outcomes. Fewer studies, assessing mainly performance, were identified for visceral leishmaniasis (n = 9), filariasis and leptospirosis (each n = 5), enteric fever and schistosomiasis (each n = 3), dengue and leprosy (each n = 2), and Chagas disease, human African trypanosomiasis, and cholera (each n = 1). Reported sensitivity of rapid tests was variable depending on several factors. Overall, specificities were high (> 80%), except for schistosomiasis and cholera. Impact and implementation outcomes, mainly acceptability and cost, followed by adoption, feasibility, and sustainability of rapid tests are being evaluated in the field. Challenges to implementing rapid tests range from cultural to technical and administrative issues. Conclusions: Rapid diagnostic tests for vector-borne and other diseases of poverty are being used in the urban context with demonstrated impact on case detection. However, most evidence comes from malaria rapid diagnostics, with variable results. While rapid tests for tuberculosis and visceral leishmaniasis require further implementation studies, more evidence on performance of current tests or development of new alternatives is needed for dengue, Chagas disease, filariasis, leptospirosis, enteric fever, human African trypanosomiasis, schistosomiasis and cholera.

Ouédraogo Samiratou, Benmarhnia Tarik, Bonnet Emmanuel, Somé Paul-André, Barro Ahmed, Kafando Yamba, Soma Diloma Dieudonné, Dabiré Roch K., Saré Diane, Fournet Florence et Ridde Valéry (2018) « Evaluation of Effectiveness of a Community-Based Intervention for Control of Dengue Virus Vector, Ouagadougou, Burkina Faso », Emerging Infectious Diseases, 24 (10) (octobre). DOI : 10.3201/eid2410.180069. http://wwwnc.cdc.gov/eid/article/24/10/18-0069_article.htm.

Paul Elisabeth, Albert Lucien, Bisala Badibanga N’Sambuka, Bodson Oriane, Bonnet Emmanuel, Bossyns Paul, Colombo Sandro, De Brouwere Vincent, Dumont Alexandre, Eclou Dieudonné Sèdjro, Gyselinck Karel, Hane Fatoumata, Marchal Bruno, Meloni Remo, Noirhomme Mathieu, Noterman Jean-Pierre, Ooms Gorik, Samb Oumar Mallé, Ssengooba Freddie, Touré Laurence, Turcotte-Tremblay Anne-Marie, Van Belle Sara, Vinard Philippe et Ridde Valéry (2018) « Performance-based financing in low-income and middle-income countries: isn’t it time for a rethink? », BMJ Global Health, 3 (1) (janvier), p. e000664. DOI : 10.1136/bmjgh-2017-000664. http://gh.bmj.com/lookup/doi/10.1136/bmjgh-2017-000664.

Résumé : This paper questions the view that performance-based financing (PBF) in the health sector is an effective, efficient and equitable approach to improving the performance of health systems in low-income and middle-income countries (LMICs). PBF was conceived as an open approach adapted to specific country needs, having the potential to foster system-wide reforms. However, as with many strategies and tools, there is a gap between what was planned and what is actually implemented. This paper argues that PBF as it is currently implemented in many contexts does not satisfy the promises. First, since the start of PBF implementation in LMICs, concerns have been raised on the basis of empirical evidence from different settings and disciplines that indicated the risks, cost and perverse effects. However, PBF implementation was rushed despite insufficient evidence of its effectiveness. Second, there is a lack of domestic ownership of PBF. Considering the amounts of time and money it now absorbs, and the lack of evidence of effectiveness and efficiency, PBF can be characterised as a donor fad. Third, by presenting itself as a comprehensive approach that makes it possible to address all aspects of the health system in any context, PBF monopolises attention and focuses policy dialogue on the short-term results of PBF programmes while diverting attention and resources from broader processes of change and necessary reforms. Too little care is given to system-wide and long-term effects, so that PBF can actually damage health services and systems. This paper ends by proposing entry points for alternative approaches.

Paul Elisabeth et Ridde Valéry (2018) « Oser remettre en question un modèle voyageur ? Le cas du financement basé sur les résultats (FBR) en Afrique » (communication orale), présenté à Cinquièmes Rencontres des Études Africaines en France. 9 au 12 juillet 2018, Marseille.

Paul Elisabeth, Sieleunou Isidore et Ridde Valéry (2018) Comment utiliser l’expérience, Cahiers Realisme. Recherches Appliquées Interventionnelles en Santé et Equité, 30 p. http://www.equitesante.org/wp-content/uploads/2018/03/Numero-15-Mars-2018.pdf.

Paul et al. - 2018 - Comment utiliser l’expérience.pdf 1.4 Mio (source)

Pérez Myriam Cielo, Minoyan Nanor, Ridde Valéry, Sylvestre Marie-Pierre et Johri Mira (2018) « Comparison of registered and published intervention fidelity assessment in cluster randomised trials of public health interventions in low- and middle-income countries: systematic review », Trials, 19 (1) (décembre). DOI : 10.1186/s13063-018-2796-z. https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-018-2796-z.

Ravit Marion, Audibert Martine, Ridde Valéry, de Loenzien Myriam, Schantz Clémence et Dumont Alexandre (2018) « Do free caesarean section policies increase inequalities in Benin and Mali? », International Journal for Equity in Health, 17 (1) (décembre), p. (art 71, 12 p.). DOI : 10.1186/s12939-018-0789-x. https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-018-0789-x.

Ravit Marion, Audibert Martine, Ridde Valéry, de Loenzien Myriam, Schantz Clémence et Dumont Alexandre (2018) « Removing user fees to improve access to caesarean delivery: a quasi-experimental evaluation in western Africa », BMJ Global Health, 3 (1) (janvier), p. e000558 (11 p.). DOI : 10.1136/bmjgh-2017-000558. http://gh.bmj.com/lookup/doi/10.1136/bmjgh-2017-000558.

Résumé : Introduction Mali and Benin introduced a user fee exemption policy focused on caesarean sections in 2005 and 2009, respectively. The objective of this study is to assess the impact of this policy on service utilisation and neonatal outcomes. We focus specifically on whether the policy differentially impacts women by education level, zone of residence and wealth quintile of the household. Methods We use a difference-in-differences approach using two other western African countries with no fee exemption policies as the comparison group (Cameroon and Nigeria). Data were extracted from Demographic and Health Surveys over four periods between the early 1990s and the early 2000s. We assess the impact of the policy on three outcomes: caesarean delivery, facility-based delivery and neonatal mortality.

Ridde Valery (2018) « Les migrants climatiques et la promotion de la santé », Global Health Promotion, 25 (1), p. 91. DOI : 10.1177/1757975918762332. https://hal.science/hal-04149534.

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Ridde Valéry (2018) « Arrivée et défis du financement basé sur les résultats dans le domaine de la santé en Afrique » (communication orale), présenté à 8e Colloque de l’Association Française Economie Politique 2018 du 3 au 6 juillet 2018, Reims.

Ridde Valéry (2018) « Migrants et migrants? Tensions mondiales entre accueil et rejet: Migrants and migrants? Global tensions between welcome and rejection », Canadian Journal of Public Health, 109 (3) (septembre 5), p. 281-283. (10.17269/s41997-018-0120-z). DOI : 10.17269/s41997-018-0120-z. http://link.springer.com/10.17269/s41997-018-0120-z.

Ridde Valéry (2018) « La gestion des conflits d'intérêt dans un jury de thèse de doctorat », Canadian journal of bioethics / Revue canadienne de bioéthique, 1 (2), p. 37. https://hal.science/hal-04102483.

Résumé : Un chercheur ou un enseignant universitaire est souvent amené à être membre d'un jury de thèse. Cela fait partie de ses activités scientifiques. Cependant, dans un monde académique de plus en plus spécialisé, il est parfois difficile de créer un jury de thèse sans être confronté à des conflits d'intérêts entre les membres et l'équipe d'encadrement. Si certaines universités ont organisé des processus pour gérer ces conflits depuis quelques années, d'autres n'ont pas encore statué. Cette étude de cas adapte plusieurs situations réelles pour montrer les défis d'une telle gestion des conflits d'intérêts dans la constitution d'un jury de thèse de doctorat.

Mots-clés : ⛔ No DOI found.

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Ridde Valéry (2018) « Climate migrants and health promotion », Global Health Promotion, 25 (1) (mars), p. 3-5. DOI : 10.1177/1757975918762330. http://journals.sagepub.com/doi/10.1177/1757975918762330.

Ridde Valéry (2018) « L'utilisation de données de recherche sans votre accord lors d'un partenariat de santé mondiale », Canadian Journal of Bioethics / Revue canadienne de bioéthique, 1 (2) (février 27), p. 22-23. DOI : 10.7202/1058275ar. https://cjb-rcb.ca/index.php/cjb-rcb/article/view/32.

Résumé : Global health research is most often spent in a context of international collaboration, particularly North-South. The particular context of this type of partnership (power, money, distance, norms, training, etc.) can lead to important issues in the use of the data collected. This case study enables the reader to reflect on this particular issue and the actions that could be taken to deal with it.

Full Text PDF 334.5 kio (source)

Ridde Valéry (2018) « Publication et collaboration avec le financeur d'un contrat de recherche », Canadian Journal of Bioethics / Revue canadienne de bioéthique, 1 (2) (février 27), p. 24-25. DOI : 10.7202/1058276ar. https://cjb-rcb.ca/index.php/cjb-rcb/article/view/30/24.

Résumé : Cette étude de cas en santé mondiale met au jour les enjeux éthiques associés à la signature scientifique dans le contexte d’un contrat de recherche octroyé par une organisation nternationale.

Ridde Valéry (2018) « Partager et renforcer les capacités d’enseignement au Sud : les défis déontologiques des droits d’auteurs », Canadian Journal of Bioethics Revue canadienne de bioéthique, 1 (2), p. Open Issue. DOI : 10.7202/1058279ar. https://cjb-rcb.ca/index.php/cjb-rcb/article/view/46.

Ridde Valery (2018) « Los migrantes climáticos y la promoción de la salud », Global Health Promotion, 25 (1), p. 99. DOI : 10.1177/1757975918762331. https://hal.science/hal-04149532.

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Ridde Valéry, Asomaning Antwi Abena, Boidin Bruno, Chemouni Benjamin, Hane Fatoumata et Touré Laurence (2018) « Time to abandon amateurism and volunteerism: addressing tensions between the Alma-Ata principle of community participation and the effectiveness of community-based health insurance in Africa10.1136/bmjgh-2018-001056 », BMJ Global Health, 3 (Suppl 3) (octobre), p. e001056. DOI : 10.1136/bmjgh-2018-001056. http://gh.bmj.com/lookup/doi/10.1136/bmjgh-2018-001056.

Résumé : Forty years after the 1978 Alma-Ata declaration, the second international conference on primary health care in October 2018 is expected to reaffirm the place of communities in health systems management and governance. In parts of Africa, community-based health insurance (CBHI)—with communities at the centre—is still seen as a strategy for achieving universal health coverage (UHC)—but there are tensions between the Alma-Ata principle of community participation, as currently interpreted, and CBHI. The tension relates particularly to the community’s role in terms of the voluntary nature of CBHI membership and volunteer involvement of the community in governance andmanagement—this tension requires a rethink of the role of communities in CBHI. We use examples of Rwanda, Ghana, Mali and Senegal to demonstrate the challenges associated with the place of communities in CBHI, and the need to reduce the role of community volunteers in CBHI and instead focus on professionalising management. Countries that still wish to rely on CBHIs for UHC must find ways to make populations enrolment compulsory, and strengthen the professionalisation of CBHI management, while also ensuring that communities continue to have a place in CBHI governance.

Ridde Valéry, Gautier Lara, Turcotte-Tremblay Anne-Marie, Sieleunou Isidore et Paul Elisabeth (2018) « Performance-based Financing in Africa: Time to Test Measures for Equity », International Journal of Health Services, 48 (3) (juillet), p. 549-561. DOI : 10.1177/0020731418779508. http://journals.sagepub.com/doi/10.1177/0020731418779508.

Résumé : Over the past 15 years, hundreds of millions of dollars have been invested in reforms founded on performance-based financing (PBF) in low- and middle-income countries. While evidence on its effectiveness and efficiency is still controversial, there appears to be an emerging consensus that equity has not been adequately considered. In this article, we show how PBF-type interventions in Africa have not sufficiently taken into account equity of access to care for the worst-off and their financial protection. In reviewing the history of health reforms in Africa, we show that this omission is nothing new. We suggest that strategic purchasing and PBF-type actions would benefit from being implemented in ways that promote equity and the financial protection of populations in Africa. Without such a reorientation of reforms, it will be impossible to achieve universal health coverage by 2030.

Ridde Valéry, Leppert Gerald, Hien Hervé, Robyn Paul Jacob et De Allegri Manuela (2018) « Street-level workers’ inadequate knowledge and application of exemption policies in Burkina Faso jeopardize the achievement of universal health coverage: evidence from a cross-sectional survey », International Journal for Equity in Health, 17 (5), p. (13 p.). DOI : 10.1186/s12939-017-0717-5. https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-017-0717-5.

Résumé : Street-level workers play a key role in public health policies in Africa, as they are often the ones to ensure their implementation. In Burkina Faso, the State formulated two different user-fee exemption policies for indigents, one for deliveries (2007), and one for primary healthcare (2009). The objective of this study was to measure and understand the determinants of street-level workers’ knowledge and application of these exemption measures.

Ridde Valéry, Sambieni N'koué Emmanuel, Kojoue Larissa et Samb Oumar Mallé (2018) Réformer les per diem par le dialogue. (40), Paris : AFD -Agence Française de Développement, 57 p. (Notes techniques). https://www.afd.fr/sites/afd/files/2018-02-12-07-23/40-notes-techniques.pdf.

Mots-clés : Education, PAYS EN DEVELOPPEMENT, recherche.

Ridde Valéry et Yaméogo Pierre (2018) « How Burkina Faso used evidence in deciding to launch its policy of free healthcare for children under five and women in 2016 », Palgrave Communications, 4 (1) (décembre), p. 9 p. DOI : 10.1057/s41599-018-0173-x. http://www.nature.com/articles/s41599-018-0173-x.

Résumé : Article | OPEN | Published: 02 October 2018 How Burkina Faso used evidence in deciding to launch its policy of free healthcare for children under five and women in 2016 Valéry Ridde & Pierre Yaméogo Palgrave Communicationsvolume 4, Article number: 119 (2018) | Download Citation Abstract In March 2016, the newly elected government of Burkina Faso decided on a major change in health financing policy: it abolished direct payment for healthcare for women and children under five. Unlike other countries in Africa, this decision took a long time, given that the first pilot projects for this policy instrument date from 2008. This article describes that political process and presents a reflexive analysis by two authors who were at the heart of events between 2008 and 2018. The analysis shows that, while the decision took a long time and certainly amounted to a policy paradigm shift, it was the result of a complex series of events and activities whose specific contributions are difficult to identify. Crucial to the decision was long-term funding of pilot projects to test the new policy instrument, associated with the generation of evidence mobilised through a myriad of knowledge transfer activities. Moreover, it took the continued mobilisation of advocacy coalitions, action to counter preconceived notions about this instrument, and the emergence of an essential window of opportunity—the 2014 popular uprising—for the decision to be possible. In this discussion, we generalise to the conceptual and theoretical levels, but also share practical lessons learned for those interested in engaging in evidence-informed decision-making. The main lessons are: recruit, train, and mobilise people and/or services responsible for knowledge transfer activities; identify and partner with political entrepreneurs early and regularly; be persistent and consistent in producing rigorous and useful knowledge; favour independent evaluation teams using mixed methods; train researchers in policy decision-making processes and decision-makers in knowledge production issues; adapt (content, format, vocabulary, language, etc.) the evidence to the needs of the knowledge users in close collaboration with researchers and disseminate it to target audiences; understand the sometimes different logics of researchers and decision-makers and encourage their interaction; to seize opportunities, regularly analyse the political decision-making processes specific to the national context as well as the social and political contexts favourable (or not) to decision-making.

Sadoine Margaux L., Smargiassi Audrey, Ridde Valéry, Tusting Lucy S. et Zinszer Kate (2018) « The associations between malaria, interventions, and the environment: a systematic review and meta-analysis », Malaria Journal, 17 (1). DOI : 10.1186/s12936-018-2220-x. https://malariajournal.biomedcentral.com/articles/10.1186/s12936-018-2220-x.

Résumé : Malaria transmission is driven by multiple factors, including complex and multifaceted connections between malaria transmission, socioeconomic conditions, climate and interventions. Forecasting models should account for all significant drivers of malaria incidence although it is first necessary to understand the relationship between malaria burden and the various determinants of risk to inform the development of forecasting models. In this study, the associations between malaria risk, environmental factors, and interventions were evaluated through a systematic review.

Samb Oumar Mallé et Ridde Valery (2018) « The impact of free healthcare on women's capability: A qualitative study in rural Burkina Faso », Social Science & Medicine, 197 (janvier), p. 9-16. DOI : 10.1016/j.socscimed.2017.11.045. https://www.sciencedirect.com/science/article/pii/S0277953617307189.

Résumé : In March 2006, the government of Burkina Faso implemented an 80% subsidy for emergency obstetric and neonatal care (EmONC). To complement this subsidy, an NGO decided to cover the remaining 20% in two districts of the country, making EmONC completely free for women there. In addition, the NGO instituted fee exemptions for children under five years of age in those two districts. We conducted a qualitative study in 2011 to examine the impact of these free healthcare interventions on women's capability. We conducted semi-structured interviews with 40 women, 16 members of health centre management committees, and eight healthcare workers in three health districts, as well as a documentary analysis. Results showed free healthcare helped reinforce women's capability to make health decisions by eliminating the need for them to negotiate access to household resources, which in turn helped shorten delays in health services use. Other effects were also observed, such as increased self-esteem among the women and greater respect within their marital relationship. However, cultural barriers remained, limiting women's capability to achieve certain things they valued, such as contraception. In conclusion, this study's results illustrate the transformative effect that eliminating fees for obstetric care can have on women's capability to make health decisions and their social position. Furthermore, if women's capability is to be strengthened, the results impel us to go beyond health and to organize social and economic policies to reinforce their positions in other spheres of social life.

Mots-clés : Access, Burkina Faso, Capability, Empowerment, Free healthcare, Gender, Qualitative method, Social norms.

ScienceDirect Full Text PDF 517.8 kio (source)

Saré Diane, Pérez Dennis, Somé Paul-André, Kafando Yamba, Barro Ahmed et Ridde Valéry (2018) « Community-based dengue control intervention in Ouagadougou: intervention theory and implementation fidelity », Global Health Research and Policy, 3 (1) (décembre). DOI : 10.1186/s41256-018-0078-7. https://ghrp.biomedcentral.com/articles/10.1186/s41256-018-0078-7.

Turcotte-Tremblay Anne-Marie, De Allegri Manuela, Gali-Gali Idriss Ali et Ridde Valéry (2018) « The unintended consequences of combining equity measures with performance-based financing in Burkina Faso », International Journal for Equity in Health, 17 (1) (décembre). DOI : 10.1186/s12939-018-0780-6. https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-018-0780-6.

Résumé : Background: User fees and poor quality of care contribute to low use of healthcare services in Burkina Faso. The government implemented an innovative intervention that combines equity measures with performance-based financing (PBF). These health equity measures included a community-based selection of indigents to receive user fee exemptions and paying healthcare centres higher purchase prices for services provided to indigents. Research suggests complex interventions can trigger changes not targeted by program planners. To date, however, there is a knowledge gap regarding the unintended consequences that can emerge from combining PBF with health equity measures. Our objective is to document unintended consequences of the equity measures in this complex intervention. Methods: We developed a conceptual framework using the diffusion of innovations theory. For the design, we conducted a multiple case study. The cases were four healthcare facilities in one district. We collected data through 93 semi-structured interviews, informal discussions, observation, as well as intervention documents. We conducted thematic analysis using a hybrid deductive-inductive approach. We also used secondary data to describe the monthly evolution of services provided to indigent and non-indigent patients before and after indigent cards were distributed. Time series graphs were used to validate some results. Results: Local actors, including members of indigent selection committees and healthcare workers, re-invented elements of the PBF equity measures over which they had control to increase their relative advantage or to adapt to implementation challenges and context. Some individuals who did not meet the local conceptualization of indigents were selected to the detriment of others who did. Healthcare providers believed that distributing free medications led to financial difficulties and drug shortages, especially given the low purchase prices and long payment delays. Healthcare workers adopted measures to limit free services delivered to indigents, which led to conflicts between indigents and providers. Ultimately, selected indigents received uncertain and unequal coverage. Conclusions: The severity of unintended consequences undermined the effectiveness and equity of the intervention. If the intervention is prolonged and expanded, decision-makers and implementers will have to address these unintended consequences to reduce inequities in accessing care.

Turcotte-Tremblay Anne-Marie, Gautier Lara, Bodson Oriane, Sambieni Emmanuel et Ridde Valéry (2018) « Le rôle des acteurs de la santé mondiale dans l’expansion du financement basé sur la performance dans les pays à faible et à moyen revenu. », Journal de Gestion et d’Économie Médicales, 36 (5-6), p. 261-279. DOI : 10.3917/jgem.185.0261.

Yaogo Maurice, Gali-Gali Idriss Ali, Keita A., Koudougou V., Sanon V-P et Ridde Valéry (2018) « Effets d'une intervention à l'échelle sur le personnel et les structures de santé : le cas du financement basé sur les résultats dans le district de Diébougou, Communication orale, » (communication orale), présenté à Journées des Sciences de la Santé de Bobo-Dioulasso, 19e édition,, Bobo-Dioulasso, Burkina Faso.

Zitti Tony, Coulibaly Abdourahmane, Ridde Valéry et Dagenais Christian (2018) « Le payement des primes individuelles liées au FBR au Mali: les consignes officielles sont-elles indispensables ? », Miseli, l'Anthropologie dans le développement. http://www.miselimali.org/fs/FBR_PB_MEO/dxcam-PB_Le_payement_des_primes_individuelles_liees_au_FBR_au_Mali.pdf.

Résumé : Les primes FBR ont été payées aux agents des centres de santé de référence (CSRéf) et des centres de santé communautaire (CSCom) avec plusieurs mois de retard. Selon les procédures définies par les concepteurs du projet, le calcul des primes devrait tenir compte du niveau de diplôme, des résultats quantitatifs et qualitatifs de chaque agent. L’étude a montré que la distribution des primes s’est déroulée de manière différente d’une formation sanitaire à une autre et qu’elle a peu respecté les procédures. Cette note donne des détails sur ces différents constats et formule des recommandations pour aider les décideurs à mieux organiser le partage des primes lors de la mise en œuvre des futurs projets.

Zongo Sylvie, Carabali Mabel, Munoz Marie et Ridde Valéry (2018) « Dengue rapid diagnostic tests: Health professionals’ practices and challenges in Burkina Faso », SAGE Open Medicine, 6 (janvier), p. 205031211879458. DOI : 10.1177/2050312118794589. http://journals.sagepub.com/doi/10.1177/2050312118794589.

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