Estimation of maternal and child mortality one year after user-fee elimination: an impact evaluation and modelling study in Burkina Faso.
Bull World Health Organ
; 92(10): 706-15, 2014 Oct 01.
Article
em En
| MEDLINE
| ID: mdl-25378724
ABSTRACT
OBJECTIVE:
To estimate the impact on maternal and child mortality after eliminating user fees for pregnant women and for children less than five years of age in Burkina Faso.METHODS:
Two health districts in the Sahel region eliminated user fees for facility deliveries and curative consultations for children in September 2008. To compare health-care coverage before and after this change, we used interrupted time series, propensity scores and three independent data sources. Coverage changes were assessed for four variables women giving birth at a health facility, and children aged 1 to 59 months receiving oral rehydration salts for diarrhoea, antibiotics for pneumonia and artemesinin for malaria. We modelled the mortality impact of coverage changes in the Lives Saved Tool using several scenarios.FINDINGS:
Coverage increased for all variables, however, the increase was not statistically significant for antibiotics for pneumonia. For estimated mortality impact, the intervention saved approximately 593 (estimate range 168-1060) children's lives in both districts during the first year. This lowered the estimated under-five mortality rate from 235 deaths per 1000 live births in 2008 to 210 (estimate range 189-228) in 2009. If a similar intervention were to be introduced nationwide, 14,000 to 19,000 (estimate range 4000-28,000) children's lives could be saved annually. Maternal mortality showed a modest decrease in all scenarios.CONCLUSION:
In this setting, eliminating user fees increased use of health services and may have contributed to reduced child mortality.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Mortalidade Materna
/
Mortalidade da Criança
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Honorários e Preços
Tipo de estudo:
Health_economic_evaluation
/
Prognostic_studies
Limite:
Child, preschool
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Female
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Humans
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Infant
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Male
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Newborn
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Pregnancy
País/Região como assunto:
Africa
Idioma:
En
Revista:
Bull World Health Organ
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Canadá