Journal of Public Health Policy

, Volume 33, Issue 4, pp 439–453 | Cite as

The impact of targeted subsidies for facility-based delivery on access to care and equity – Evidence from a population-based study in rural Burkina Faso

  • Manuela De AllegriEmail author
  • Valéry Ridde
  • Valérie R Louis
  • Malabika Sarker
  • Justin Tiendrebéogo
  • Maurice Yé
  • Olaf Müller
  • Albrecht Jahn
Original Article


We conducted the first population-based impact assessment of a financing policy introduced in Burkina Faso in 2007 on women's access to delivery services. The policy offers an 80 per cent subsidy for facility-based delivery. We collected information on delivery in five repeated cross-sectional surveys carried out from 2006 to 2010 on a representative sample of 1050 households in rural Nouna Health District. Over the 5 years, the proportion of facility-based deliveries increased from 49 to 84 per cent (P<0.001). The utilization gap across socio-economic quintiles, however, remained unchanged. The amount received for all services associated with births decreased by 67 per cent (P<0.001), but women continued to pay on average 1423 CFA (€1=655 CFA), about 500 CFA more than the set tariff of 900 CFA. Our findings indicate the operational effectiveness of the policy in increasing the use of facility-based delivery services for women. The potential to reduce maternal mortality substantially has not yet been assessed by health outcome measures of neonatal and maternal mortality.


user fee abolition maternal care sub-Saharan Africa targeted subsidies equity 


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Copyright information

© Palgrave Macmillan, a division of Macmillan Publishers Ltd 2012

Authors and Affiliations

  • Manuela De Allegri
    • 1
    Email author
  • Valéry Ridde
    • 2
  • Valérie R Louis
    • 1
  • Malabika Sarker
    • 1
    • 4
  • Justin Tiendrebéogo
    • 3
  • Maurice Yé
    • 3
  • Olaf Müller
    • 1
  • Albrecht Jahn
    • 1
  1. 1.Institute of Public Health, University of HeidelbergHeidelbergGermany
  2. 2.Centre de recherche du Centre Hospitalier de l’Université de Montréal. (CRCHUM) and Département de Médecine Sociale et Préventive, Université de MontréalCanada
  3. 3.Centre de Recherche en Santé de NounaNounaBurkina Faso
  4. 4.BRAC School of Public HealthBangladesh

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