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

J Public Health Policy. 2012 Nov;33(4):439-53. doi: 10.1057/jphp.2012.27. Epub 2012 Aug 30.


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 (\[euro]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.

MeSH terms

  • Adult
  • Burkina Faso
  • Cross-Sectional Studies
  • Delivery of Health Care / economics
  • Delivery of Health Care / organization & administration*
  • Delivery, Obstetric / economics
  • Delivery, Obstetric / statistics & numerical data
  • Female
  • Financing, Government / economics
  • Financing, Government / organization & administration
  • Financing, Personal / statistics & numerical data
  • Health Care Costs / statistics & numerical data
  • Health Services Accessibility / economics
  • Health Services Accessibility / organization & administration*
  • Humans
  • Maternal Health Services / economics
  • Maternal Health Services / organization & administration
  • Maternal Health Services / statistics & numerical data
  • Rural Population