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Making health care more affordable in Burkina Faso, Mali, and Niger


In the 1980s, with advice from international organizations, most African countries adopted direct payment for health services as the primary means to finance their health systems. Patients had to pay for health services out-of-pocket, severely hindering access to services for the most vulnerable. New recommendations in the 2000s called for African countries to offer subsidies or abolish payments for certain health services and groups. Until now, the impacts of these reforms in francophone West Africa have not been documented.

An IDRC-funded project led by the Laboratoire d’études et de recherche sur les dynamiques sociales et le development local (LASDEL) in Niger and the Centre hospitalier de l’Université de Montréal (CHUM) in Canada examined the effects of removing or subsidizing direct payment for health services in Burkina Faso, Mali, and Niger.

The research identifies major challenges in the countries' health services and suggests strategies for improving equity and access to health systems, especially for women, children, and those requiring treatment for HIV/AIDS and malaria. 

Collaboration with regional partners in West Africa, including MISELI, Africsanté, and the Centre national de recherche scientifique et technologique au Burkina Faso, was central to the project.

By encouraging close interaction with decision-makers and health providers in West Africa, the research is informing debates on reforms for more equitable health systems in West Africa.

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