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Characterisation of the rural indigent population in Burkina Faso: a screening tool for setting priority healthcare services in sub-Saharan Africa
BACKGROUND: In Africa, health research on indigent people has focused on how to target them for services, but little research has been conducted to identify the social groups that compose indigence. Our aim was to identify what makes someone indigent beyond being recognised by the community as needi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Open
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640067/ https://www.ncbi.nlm.nih.gov/pubmed/28993378 http://dx.doi.org/10.1136/bmjopen-2016-013405 |
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author | Ouédraogo, Samiratou Ridde, Valéry Atchessi, Nicole Souares, Aurélia Koulidiati, Jean-Louis Stoeffler, Quentin Zunzunegui, Maria-Victoria |
author_facet | Ouédraogo, Samiratou Ridde, Valéry Atchessi, Nicole Souares, Aurélia Koulidiati, Jean-Louis Stoeffler, Quentin Zunzunegui, Maria-Victoria |
author_sort | Ouédraogo, Samiratou |
collection | PubMed |
description | BACKGROUND: In Africa, health research on indigent people has focused on how to target them for services, but little research has been conducted to identify the social groups that compose indigence. Our aim was to identify what makes someone indigent beyond being recognised by the community as needing a card for free healthcare. METHODS: We used data from a survey conducted to evaluate a state-led intervention for performance-based financing of health services in two districts of Burkina Faso. In 2015, we analysed data of 1783 non-indigents and 829 people defined as indigents by their community in 21 villages following community-based targeting processes. Using a classification tree, we built a model to select socioeconomic and health characteristics that were likely to distinguish between non-indigents and indigents. We described the screening performance of the tree using data from specific nodes. RESULTS: Widow(er)s under 45 years of age, unmarried people aged 45 years and over, and married women aged 60 years and over were more likely to be identified as indigents by their community. Simple rules based on age, marital status and gender detected indigents with sensitivity of 75.6% and specificity of 55% among those 45 years and over; among those under 45, sensitivity was 85.5% and specificity 92.2%. For both tests combined, sensitivity was 78% and specificity 81%. CONCLUSION: In moving towards universal health coverage, Burkina Faso should extend free access to priority healthcare services to widow(er)s under 45, unmarried people aged 45 years and over, and married women aged 60 years and over, and services should be adapted to their health needs. ETHICS CONSIDERATIONS: The collection, storage and release of data for research purposes were authorised by a government ethics committee in Burkina Faso (Decision No. 2013-7-066). Respondent consent was obtained verbally. |
format | Online Article Text |
id | pubmed-5640067 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BMJ Open |
record_format | MEDLINE/PubMed |
spelling | pubmed-56400672017-10-19 Characterisation of the rural indigent population in Burkina Faso: a screening tool for setting priority healthcare services in sub-Saharan Africa Ouédraogo, Samiratou Ridde, Valéry Atchessi, Nicole Souares, Aurélia Koulidiati, Jean-Louis Stoeffler, Quentin Zunzunegui, Maria-Victoria BMJ Open Global Health BACKGROUND: In Africa, health research on indigent people has focused on how to target them for services, but little research has been conducted to identify the social groups that compose indigence. Our aim was to identify what makes someone indigent beyond being recognised by the community as needing a card for free healthcare. METHODS: We used data from a survey conducted to evaluate a state-led intervention for performance-based financing of health services in two districts of Burkina Faso. In 2015, we analysed data of 1783 non-indigents and 829 people defined as indigents by their community in 21 villages following community-based targeting processes. Using a classification tree, we built a model to select socioeconomic and health characteristics that were likely to distinguish between non-indigents and indigents. We described the screening performance of the tree using data from specific nodes. RESULTS: Widow(er)s under 45 years of age, unmarried people aged 45 years and over, and married women aged 60 years and over were more likely to be identified as indigents by their community. Simple rules based on age, marital status and gender detected indigents with sensitivity of 75.6% and specificity of 55% among those 45 years and over; among those under 45, sensitivity was 85.5% and specificity 92.2%. For both tests combined, sensitivity was 78% and specificity 81%. CONCLUSION: In moving towards universal health coverage, Burkina Faso should extend free access to priority healthcare services to widow(er)s under 45, unmarried people aged 45 years and over, and married women aged 60 years and over, and services should be adapted to their health needs. ETHICS CONSIDERATIONS: The collection, storage and release of data for research purposes were authorised by a government ethics committee in Burkina Faso (Decision No. 2013-7-066). Respondent consent was obtained verbally. BMJ Open 2017-10-08 /pmc/articles/PMC5640067/ /pubmed/28993378 http://dx.doi.org/10.1136/bmjopen-2016-013405 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Global Health Ouédraogo, Samiratou Ridde, Valéry Atchessi, Nicole Souares, Aurélia Koulidiati, Jean-Louis Stoeffler, Quentin Zunzunegui, Maria-Victoria Characterisation of the rural indigent population in Burkina Faso: a screening tool for setting priority healthcare services in sub-Saharan Africa |
title | Characterisation of the rural indigent population in Burkina Faso: a screening tool for setting priority healthcare services in sub-Saharan Africa |
title_full | Characterisation of the rural indigent population in Burkina Faso: a screening tool for setting priority healthcare services in sub-Saharan Africa |
title_fullStr | Characterisation of the rural indigent population in Burkina Faso: a screening tool for setting priority healthcare services in sub-Saharan Africa |
title_full_unstemmed | Characterisation of the rural indigent population in Burkina Faso: a screening tool for setting priority healthcare services in sub-Saharan Africa |
title_short | Characterisation of the rural indigent population in Burkina Faso: a screening tool for setting priority healthcare services in sub-Saharan Africa |
title_sort | characterisation of the rural indigent population in burkina faso: a screening tool for setting priority healthcare services in sub-saharan africa |
topic | Global Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640067/ https://www.ncbi.nlm.nih.gov/pubmed/28993378 http://dx.doi.org/10.1136/bmjopen-2016-013405 |
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