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International Journal for Quality in Health Care Advance Access originally published online on October 18, 2005
International Journal for Quality in Health Care 2006 18(1):30-34; doi:10.1093/intqhc/mzi079
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International Journal for Quality in Health Care vol. 18 no. 1 © The Author 2005. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved

Quality of care of modern health services as perceived by users and non-users in Burkina Faso

Rob Baltussen1 and Yazoume Ye2

1 Institute for Medical Technology Assessment, Erasmus MC, Rotterdam, The Netherlands and 2 Department of Tropical Hygiene and Public Health, Heidelberg University, Heidelberg, Germany

Objective. Only one-fifth of the population in rural Burkina Faso uses modern health services. This article aims to identify barriers to increased use, which may help decision makers to develop policies to remove them.

Design. This article compares perceived quality of care of 853 pairs of users and non-users of modern health services. Non-users were matched to users on age, sex, occupation of the head of the household and distance to health post. Questions were structured according to four dimensions of quality of care.

Setting. Nouna health care district, Burkina Faso.

Results. Both users and non-users were relatively favourable about health personnel practices and conduct (77% versus 70% of the maximum attainable score), and about health care delivery (77% versus 74%). They were less favourable about adequacy of resources and services (51% versus 46%), and financial and physical accessibility of care (57% versus 51%). Both groups were very negative regarding the availability of drugs (33% versus 27%). Users were more favourable than non-users overall (66% versus 61%), and especially regarding payment arrangements (51% versus 43%) and costs (50% versus 40%). Observed differences were generally significant.

Conclusion. To remove barriers to increase utilization, policy makers may do good to target their attention to improve financial accessibility of modern health services and improve drugs availability. These factors seem most persistent in decisions of ill people to stay with home-based care and/or traditional medicine, or go to consult modern health services.

Keywords: qulity of care, burkina faso, utilization

Address reprint requests to Rob Baltussen, Institute for Medical Technology Assessment, Erasmus MC, PO Box 1738, 3000 DR, Rotterdam, The Netherlands. E-mail: r.baltussen{at}erasmusmc.nl

Accepted for publication September 10, 2005.


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