Bulletin de la Société de pathologie exotique

, Volume 106, Issue 4, pp 264–271 | Cite as

La charge de travail des agents de santé dans un contexte de gratuité des soins au Burkina Faso et au Niger

Santé Publique / Public Health

Résumé

La mise en place des mécanismes de subvention ou de gratuité des soins appuyés par les ONG au Burkina Faso et au Niger a entraîné une hausse importante de l’utilisation des services de santé de première ligne. Face à l’augmentation de la charge de travail perçue par le personnel soignant, l’objectif de cette étude était de mesurer leur charge de travail effective et d’estimer si les agents de santé étaient en mesure de faire face à la hausse engendrée par cette augmentation. Nous avons utilisé la méthodeWISN recommandé par l’OMS pour évaluer leur disponibilité en comparant, dans chaque pays, quatre centres de santé où intervient une ONG par rapport à quatre autres centres de santé où seule la politique de l’État est mise en place. Huit centres de centre ont été concernés par cette étude au niveau de chaque pays en 2011. Au Burkina Faso, l’effectif du personnel était supérieur ou égal à l’effectif requis dans les huit centres de santé. Au Niger, trois centres de santé sur quatre du district sanitaire de Keita (présence d’ONG) présentaient un effectif en personnel inférieur ou égal à l’effectif requis (Wisn ratio ≤ 1). Par contre, à Abalak (absence d’ONG), les centres de santé présentaient des effectifs supérieurs ou égaux aux effectifs requis (Wisn ratio ≥ 1). Cette étude montre que l’effectif en ressources humaines ne s’est pas adapté au Niger dans le cadre de la gratuité des soins soutenue par une ONG. Au Burkina Faso, cet effectif est actuellement suffisant pour faire face à la gratuité totale.

Mots clés

Charge de travail Gratuité de soins Agent de santé Absentéisme Dori Gorom Gorom Sebba Keita Abalak Burkina Faso Niger Afrique intertropicale 

Heath staff workload in a context of user fees exemption policy for health care in Burkina Faso and Niger

Abstract

User fees exemption policy supported by NGOs in Burkina Faso and Niger resulted in a higher utilization of health services in primary health care facilities. We conducted a survey in 2 health districts in Burkina Faso and Niger in 2011. The study objective was to assess whether the higher utilization associated with the user fees exemption policy, may result in an overload for health staff at the front line in health facilities. The WHO’s recommended WISN method was used to compute a ratio of actual/required staff using a comparative study with 4 control facilities and 4 intervention sites where the user fees exemption policy was provided by local NGOs in both countries. Overall, 8 primary health facilities both in Burkina Faso and Niger were involved. In Burkina Faso, the ratio was ≥1 in all facilities both control and intervention, i.e. a sufficient staff in facilities. In Niger, 3 out of the 4 intervention facilities in Keita district were found to have a ratio ≤1, i.e. understaffed. In the 4 control facilities, the staff was sufficient with a ratio ≥1. In Burkina Faso, the actual number of staff in facilities appeared enough to face the higher utilization of health services that may follow the user fees exemption policy supported by local NGOs unlike Niger where we found that the actual number of staff was insufficient to face a possible higher utilization resulting from the same policy in intervention facilities.

Keywords

Workload User fees exemption Health staff Absenteeism Dori Gorom-Gorom Sebba Keita Abalak Burkina Faso Niger Sub-Saharan Africa 

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Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  1. 1.Département de santé publique et de biologie médicaleInstitut de recherche en sciences de la santé (IRSS)Ouagadougou 03Burkina Faso
  2. 2.École de santé publique de l’université de MontréalCentre de recherche du Centre hospitalier de l’Université de Montréal (CHUM)MontréalCanada
  3. 3.Centre de recherche du Centre hospitalier de l’Université de Montréal (CHUM)MontréalCanada

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