Local initiatives to access emergency obstetric and neonatal care in Burkina Faso.
OBJECTIVE
To describe the various local initiatives to access emergency obstetric and neonatal care in Burkina Faso.


METHODS
An existing framework was used to review the three processes for local initiatives: emergence, formulation, and implementation. Multiple case studies were conducted, followed by literature review and semi-structured interviews with key informants.


RESULTS
Sixteen districts had implemented local initiatives, including cost sharing, free care for women and children, and free care for delivery and cesareans. Most districts (n=10) had implemented the cost-sharing intervention. These initiatives were initiated by local actors as well as nongovernmental organizations. The profile of those involved led to different ways of handling the emergence and formulation processes. At implementation, these initiatives faced many issues including late payment of contributions, low involvement of local governments, and equity in participation.


CONCLUSIONS
There are some issues in the implementation and sustainability of the local initiatives. Although many initiatives exist, these are unable to fully address the financial barriers to care. However, these initiatives highlight context-based financial barriers that must be taken into account to accelerate universal access to health care.
African Public Health Institute, Ouagadougou, Burkina Faso. Electronic address: yamwamb@gmail.com.
Wambi M E
WM
Yaméogo
Ministry of Health, Ouagadougou, Burkina Faso.
Talatou M
TM
Ouédraogo
African Public Health Institute, Ouagadougou, Burkina Faso; Institute of Research in Health Science, Ouagadougou, Burkina Faso.
Seni
S
Kouanda
D002050:Burkina Faso; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007229:Infant Welfare / Q000706:statistics & numerical data; D007231:Infant, Newborn; D008429:Maternal Welfare / Q000706:statistics & numerical data; D000068101:Maternal-Child Health Services / Q000706:statistics & numerical data*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000517:prevention & control; D019984:Quality Indicators, Health Care
Burkina Faso; EmONC; Emergency obstetric and neonatal care; Health financing; Health policy