Analysis of the implementation of large-scale community selection of indigents in Sub-Saharan Africa: the case of Burkina Faso
Keywords:
Analysis, Implementation, Community selection, IndigentAbstract
Indigent do not have access to health care, and selecting them from a predominantly poor population poses enormous challenges. Little evidence exists on the selection of indigents in relation to the performance of health services. The objective of this study is to analyse the implementation of indigent selection conducted in Burkina Faso, with a view to informing decisions for scaling up with universal health insurance. This is a research on implementation based on a multiple case study coupled with a reflective approach. The cases were the subject of reasoned choice according to the indigent’s selection. A conceptual model adapted from the Consolidated Framework for Implementation Research is used, considering the implementation of community-based selection of indigents as the result of the influence and interaction of the selection process, the steps, the actors, the organisation and the context, and the data collection tools. Data is collected through interviews and document review. Three coordination structures and two implementation structures are set up for the selection. Socio-political unrest and vaccination and drug administration campaigns disrupted the selection process. The selection process was subject to adaptations and power struggles between stakeholders. The desired proportion of indigents is not achieved. Selection is confronted with contextual realities and interactions between actors. A dynamic and adaptive selection process, supported by social communication, should be used in future selection process.
References
Atchessi N. (2017). Recours aux soins de santé des indigents et des personnes âgées en Afrique de l’Ouest: cas du Burkina Faso et du Nigeria: https://papyrus.bib.umontreal.ca/xmlui/handle/1866/19257
Bernard Hours. (2001). Systèmes et politiques de santé: de la santé publique à l'anthropologie, Paris, Karthala. Cahiers d’études africaines [En ligne], 201 | 2011, mis en ligne le 05 mai 2013, consulté le 15 juin 2021.
Criel B., Samba B.A., Kane F., Noirhomme M., Waelkens MP. (2010). Une expérience de protection sociale en santé pour les plus démunis: Le fonds d’indigence de Dar-Naïm en Mauritanie. Antwerp, ITG Press.
Damschroder L., Aron D., Keith R., Kirsh SR, Alexander AJ, Lowery JC. (2009). Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Sci 4, 50 DOI :10.1186/1748-5908-4-50.
Deville C, Escot F, Ridde V, Touré L. (2018). Les processus d’identification des plus pauvres à l’épreuve du terrain: une comparaison Bénin-Mali-Sénégal. APAD Roskilde University, Denmark.
Drabo KM., Sondjo G., Hien H., Tinto H., Traoré M., Valéa I., et al. (2015). Prise en charge communautaire du paludisme chez la femme enceinte au Bénin, au Burkina Faso et en Gambie. Global Health Promotion 2013 20 :10; Vol 20 DOI: 10.1177/1757975912462417.
Dyer, W.G. Jr., Wilkins, A. L. (1991). « Better stories, not better constructs, to generate better theory: a rejoinder to Eisenhardt », Academy of Management review, Vol.16, n°. 3, pp. 613-619.
Eisenhardt, K.M. (1991). Better Stories and Better Constructs: The Case for Rigor and Comparative Logic, Academy of Management Review, Vol.16 n°3, pp. 620-627.
Emerson, R. M., Fretz, R. I. & Shaw, L. L. (1995). Writing Ethnographic Fieldnotes, Chicago-London, University of Chicago Press.
INSD (2015). Enquête multisectorielle continue 2014: Profil de pauvreté et d’inégalités Ouagadougou, Burkina-Faso.
INSD, ICF International. (2012). Enquête Démographique et de Santé et à Indicateurs Multiples du Burkina-Faso 2010. Calverton, Maryland, USA: INSD et ICF International.
Ipr. (2004). Projet fonds d’équité: premier rapport et discussions successives. Etude de faisabilité dans la Zone de Santé Rurale de Bokonzi, Dongo, RDCongo: Institut pour la promotion rurale.
Jhabvala R. et Guy S. (2011). Le ciblage des politiques sociales indiennes: entre inefficacité et iniquité. Alternatives sud, vol. 18-2011 / 141.
Kaddar M., Stierle F., Schmidt-Ehry B., Tchicaya A. (2000). L'accès des indigents aux soins de santé en Afrique subsaharienne. In: Tiers-Monde, tome 41, n°164.
Kalavakonda V., Groos N. et Karasi JC. (2007). Mid-term evaluation of the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria 5th Round Project on Health Systems Strengthening. Rwanda.
Kohn L., Christiaens W. (2012). L’utilisation des méthodes qualitatives dans les études du KCE. Method. Bruxelles: Centre fédéral d’expertise des soins de santé (KCE). Report 187B. D/2012/10.273/67.
Kottak C. (2006). Mirror for Humanity. McGraw-Hill, New York. ISBN 978-0-07-803490-9.
Kouanda S., Traoré A., Kankouan J. (2009). Evaluation du processus d’identification des ménages bénéficiaires dans le cadre de l’opération emergency response to high food prices in Burkina Faso main cities. Burkina Faso – EMOP 10773.0.
Lafaye G.C. (2014). La domination sociale dans le contexte contemporain. Recherches sociologiques et anthropologiques DOI: 10.4000/rsa.1203.
Lecestre-Rollier B. (2015). Les solidarités familiales au Maroc: permanences et changements, Mondes en développement, 2015/3 (n° 171), p. 51-64. DOI: 10.3917/med.171.0051.
Lemieux, V. (2002) L'étude des politiques publiques, les acteurs et leur pouvoir, Québec, Les Presses de l'Université Laval.
Lienard G. et Mangez E. (2015). Régimes d’action et rapports de pouvoir. Vers un approfondissement de la théorie bourdieusienne de la domination? Recherches sociologiques et anthropologiques. DOI: 10.4000/rsa.1435.
Mary W.K., Klaus B., Bunnak P., Samnang B, Louise B et al. IDPoor. (2018). a poverty identification programme that enables collaboration across sectors for maternal and child health in Cambodia. BMJ ;363: k4698.
Men C. et Meessen B. (2008). Community Perceptions of Pre-identification Results and Methods in Six Health Equity Fund Areas in Cambodia. In Health and social protection: experiences from Cambodia, China and Lao PDR. Antwerp: ITGPress.
Moore GF., Audrey S., Barker M., et al. (2015). Process evaluation of complex interventions: Medical Research Council guidance. BMJ, 350, h1258.
Morestin F., Grant P. et Ridde V. (2009). Criteria and processes for identifying the poor as beneficiaries of programs in developing countries. Montreal, CRCHUM: http://www.equitesante. org/equity-of-access-to-healthcare/.
Olivier de Sardan. (1995). Anthropologie et développement. Essai en socio-anthropologie du changement social. Marseille: APAD; Paris, Karthala, Éditeur, 1995, 221 pp Collection: Hommes et société.
Olivier de Sardan Jean-Pierre. (2001). Les trois approches en anthropologie du développement. In: Tiers-Monde, tome 42, n°168. Anthropologie du développement, fiscalité, géographie industrielle, éducation DOI: https://doi.org/10.3406/tiers.2001.1546
Olivier de Sardan, J.-P. (1990). Sociétés et développement », in D. FASSIN & Y. JAFFRÉ, Sociétés, développement et santé, Paris, Ellipses: 28-37.
Pasquier-Doumer L., Lavallée E., Olivier A. et al. (2009). Cibler les politiques de lutte contre la pauvreté dans les pays en développement? Un bilan des expériences. Revue d'économie du développement, Vol. 17.
Pfadenhauer, L. M., Mozygemba, K, et al. (2015) Context and implementation: A concept analysis towards conceptual maturity. Zeitschrift Für Evidenz, Fortbildung Und Qualität Im Gesundheitswesen. 2015, 109(2), 103-114. https://doi.org/10.1016/j.zefq.2015.01.004.
Pfadenhauer, L.M., Mozygemba, K., et al., (2015): Context and implementation: A concept analysis towards conceptual maturity. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen, 109 (2). pp. 103-114. ISSN 1865-9217 https://doi.org/10.1016/j.zefq.2015.01.004.
PNUD. (1999). La lutte contre la pauvreté en Afrique subsaharienne. Paris, Economica.
Raimondeau, J., Bréchat, P., Huteau, G., Marin, P. & Naty-Daufin, P. (2020). Manuel de santé publique. Presses de l’EHESP. https://doi.org/10.3917/ehesp.raimo.2020.01
Rathwell, T. (1998). Implementing Health Care Reform: A Review of Current Experience », in R. B. Saltman, J. Figueras & C. Sakellarides (eds.), Critical Challenges for Health Care Reform in Europe, Buckingham Philadelphia, Open University Press: 385-399.
Ridde, V. et Jacob J. P. (2013). Les indigents et les politiques de santé en Afrique. Expériences et enjeux conceptuels. Louvain-La-Neuve, Academia-L’Harmattan s.a; 478p.
Ridde, V., Bonnet, E., Nikiema, A, Kadio, K. (2010). A spatial analysis of a community-based selection of indigents in Burkina Faso. Global Health Promotion DOI: 10.1177/1757975912462417.
Ridde, V., Yaogo M., Kafando Y., Kadio K., Ouédraogo M., Sanfo, M, et al. (2011) “Challenges of Scaling Up and of Knowledge Transfer in an Action Research Project in Burkina Faso to Exempt the Worst-off from Health Care User Fees. BMC International Health & Human Rights 11(Suppl 2): S9.
Saetren, H. (2014). Implementing the third-generation research paradigm in policy implementation research: An empirical assessment. Public Policy and Administration 105.https://doi.org/10.1177/0952076713513487.
Serge B. P., Perrenoud. (2016). Développer la pratique réflexive dans le métier d’enseignant. L'orientation scolaire et professionnelle [En ligne] http://journals.openedition.org/osp/4894.
SERSAP. (2014). Mise en œuvre et suivi d’un processus communautaire de sélection des indigents dans huit districts sanitaires au Burkina-Faso. Guide méthodologique du processus de ciblage. Document de travail, Ouagadougou, Burkina-Faso.
Stephen D., Edoardo M., Rachel S-W., Michael S., Althea-Maria R., Dilf L. (2017), The targeting effectiveness of social transfers, Journal of Development Effectiveness, 9:2, 162-211, DOI: 10.1080/19439342.2017.1305981.
Tremblay MC., Parent AA. (2014). Reflexivity in PHIR: Let’s have a reflexive talk! Canadian Journal of Public Health, 105.
Valéry Ridde. (2011). « Politiques publiques de santé, logiques d'acteurs et ordre négocié au Burkina Faso », Cahiers d’études africaines [En ligne] http://journals.openedition.org/etudesafricaines/16603; DOI: https://doi.org/10.4000/ Etudes africaines.16603.
Waelkens M. (2007). Assessment of the Community Health Fund in Muheza, Tanga Region, Tanzania. Institute of Tropical Medicine. Antwerp.
WHO (2010). Women and health: today's evidence tomorrow's agenda. Geneva. WHO publications.
World Bank. (2014). Where have all the poor gone? http://documents.worldbank.org/ACS45450.
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