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


METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Baltussen
Rob
R
Institute for Medical Technology Assessment, Erasmus MC, Rotterdam, The Netherlands. r.baltussen@erasmusmc.nl
Ye
Yazoume
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002050:Burkina Faso; D005260:Female; D006268:Health Facilities / Q000592:standards* / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011787:Quality of Health Care / Q000145:classification / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires