Evidence mapPaperPMID 41398924Full record

ArticleGlobal health research and policy2025

Evaluating the effects of the free healthcare policy on clinical visits and malaria among children in Burkina Faso: a modeling study of past trends and future forecasts.

André Lin Ouédraogo, Marie-Jeanne Offosse, Julie Zhang, Sylvain Toé, Pierre Yaméogo

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Article in Global health research and policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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5 · Who and what money

Authors and funding

5 authors.

André Lin OuédraogoBaobab Shift, Seattle, WA, USA. oandrelin@gmail.com.ORCID http://orcid.org/0000-0001-5880-5512
Marie-Jeanne OffosseCountry Office, ThinkWell Institute, Ouagadougou, Burkina Faso.ORCID http://orcid.org/0000-0002-7920-9135
Julie ZhangFormer Institute for Disease Modeling, Gates Foundation, Seattle, WA, USA.
Sylvain ToéTerres Des Hommes, Ouagadougou 01, 01 BP 2212, Ouagadougou, Burkina Faso.
Pierre YaméogoFormer Technical Secretary for Health Financing Reforms, Ministry of Health and Public Hygiene, Ouagadougou, Burkina Faso.ORCID http://orcid.org/0000-0001-7019-171X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccess to primary healthcare remains a major challenge in sub-Saharan Africa. In 2016, Burkina Faso introduced the free healthcare policy, eliminating financial barriers by offering free healthcare services for children under five and pregnant women. While previous studies have reported increased healthcare utilization under the policy, its effects on health outcomes remains unassessed. Here, we evaluate the free healthcare policy's effects on three key indicators: frequency of clinical visits, malaria prevalence, and severe malaria.

methodsRoutine health and demographic data for children under five were collected from health facilities using the government's Electronic Medical Record (EMR) platform. Generalized Linear Mixed Effects Models (GLMM) with a Differences-in-Differences design assessed changes in the three indicators between baseline (2015) and 2018 while Bayesian hierarchical models were used to forecast trends through 2020.

resultsAnalysis of 344,935 clinical visits from 199,664 children across 192 villages showed an increase in healthcare utilization, with clinical visits rising from 1.1 to 2 per child between 2015 and 2018 (p < 0.001) resulting in a percentage increase of 82%. However, disparities persisted, as children living within 5 km of a health facility accessed more care than those in remote areas (2.2 vs. 1.7 visits, p < 0.001). Malaria prevalence decreased from 98 to 80% (p < 0.001), and severe malaria declined from 6% to 2.2% (p < 0.001) during the same period. Bayesian forecasts indicated continued increases in clinical visits (from 2.36 in 2019 to 2.75 in 2020) and further declines in malaria prevalence (to 64%) and severe malaria (to 1.02%) by 2020.

conclusionsOur study highlights the transformative effects of the free healthcare policy in improving healthcare access and outcomes for children under five in Burkina Faso. However, inequities in access remain a challenge. Strengthening community health worker programs and expanding community health activities are critical to addressing these gaps. The findings offer valuable insights for policymakers in Burkina Faso and contribute to global efforts to leverage health reforms to improve malaria control and progress toward universal health coverage.

Indexed as

Health PolicyHealth Services AccessibilityMalariaPatient Acceptance of Health CareBayes TheoremBurkina FasoChild, PreschoolFemaleForecastingHumansInfantMalePrevalenceBayesian modelingBurkina FasoChildren under fiveDifference-in-differencesDistanceEquityFree healthcare policyGratuitéMalariaPrimary healthcare

Identifiers

PMID41398924
PMCPMC12703899

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.