National UHC Dynamics Card Burkina Faso

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General Information

Burkina Faso has an estimated population of 20,2 million and consists of 13 regions and 45 provinces. The vast majority of the population lives in rural areas and is affected by illiteracy (70.1%). The crude birth rate is 46 per 1000 inhabitants, with an annual growth rate of 3.1%. The analysis of monetary poverty indicators show, that in 2014, 40.1% of the population lived below the poverty line. This rate is accompanied by a life expectancy of 56,7 years. Burkina Faso is one of the least developed countries with an estimated gross domestic product (GDP) per capita of 354,236 CFA (USD 601.1) in 2015 remains low. As a result, health expenses are still largely covered by direct household payments (31.4% in 2016).But Burkina Faso indicators are good when comparing to most western African countries and improving (out of pocket payment, % budget dedicated to health…).

Map of Burkina_Faso
Capital

Ouagadougou 12°20’N 1°40’W

Official languages

French

Recognised language

Mòoré

Religion

47.9% Mossi, 10.3% Fula, 6.9% Lobi, 6.9% Bobo, 6.7% Mandé, 5.3% Senufo, 5.0% Gurunsi, 4.8% Gurma, 3.1% Tuareg

National UHC Dynamics Card as PDF

 

A complete overview of the UHC process in Burkina Faso can be found in the attached print version of the card.

 
 

2000 - 2005

Burkina Faso was committed to achieving the MDGs by 2015. This led to the implementation of:

1.

Free preventive and promotional care (vaccination, ANC, consultation of healthy infants, etc.)

2.

Free tuberculosis care

3.

Family Planning Subsidy

4.

Promotion and implementation of mutual health insurance.

2006 & 2007

2006

Implementation of the Emergency Obstetric and Neonatal Care (EmONC) subsidy. Provision of kits for free treatment of malaria emergencies for children under the age of five.

2007

Implementation of free care for children under the age of five by diferent NGOs (including TdH, save the children, add Help).

2008-2014

FORMAL ENGAGEMENTS TOWARDS UNIVERSAL HEALTH COVERAGE FOR ALL BURKINABE
2008-2009
Creation of the Permanent Secretariat of the Steering Committee on Health Insurance (SP-CPAM).
2010-2011
Implementation of free Antiretrovirals (ARVs).
 
2014
Creation of the Technical Secretariat of the Universal Health Insurance Scheme (STAMU) which replaces the SPCPAM (located at the Ministry of Civil Service and Social Protection).
 
 
HEALTH FINANCING

Dissemination of the study on the situation of the health financing system in Burkina Faso is carried out by the Ministry of Health with the support of the World Health Organization (WHO).

2014-2019

AMU
UNIVERSAL HEALTH INSURANCE LAW
2014

The law project on the Universal health insurance plan (RAMU) was adopted by the government and introduced to the National Assembly. It establishes a legal framework for the operationalization of health insurance in Burkina Faso.

2015
Burkina Faso is committed to achieving SDGs by 2030.

Adoption of the Universal Health Insurance law (AMU) on the compulsory health insurance scheme which aims to generalize access to health care through solidarity and mutualized financing of the solvent population and by the State subsidy for the benefit of the indigent population.

 
 
 

An average of 23% of essential medicines (MEG) have experienced drug shortages.

 
 
2016

The government decided to scale up free health care measures for women and children under the age of five. Thanks to the exemption fee mechanism, this is about 20% of the population that benefits from a financial risk protection mecanisme.

 

Ratios of Nurse to population:

1/2663

Ratios of Physician to population:

1/15836

Ratios of Midwife to population:

1/7378
2017

Creation of a Technical Secretary for Universal Health Coverage (ST-CSU), located at the level of the Ministry of Health.

 
 

The social security system covered only 7% of the population, mainly for the benefit of workers in the formal sector.

 
2018
Adoption of the national health financing strategy for UHC.
Creation of a National Universal Insurance Insitution.
Preparation and adoption of AMU strategic documents and preparation of CNAMU communication plan.

Appointment of the General Director of the National Universal Health Insurance Fund (CNAMU), which is responsible for ensuring the affiliation of employers and the registration of insured persons, the collection of contributions, the contractualization and payment of health care benefits invoices.

2019

Negociations are carried out at government level to mobilize domestic resources to start the implementation of the AMU.

 
CHALLENGE

Today, Burkina is facing very challenging issues with terrorism. This leads to a concerted effort on security, coming from the national budget, while discouraging foreign investment, which has consequences on the budgets of social sectors.

Nevertheless, the government spares no expense in providing funds to support the health sector, and in securing the necessary funds for the fee exemption mechanism & family planning (32 billion FCFA per year).

It also tries to secure funds in order to start, even if slowly, the Universal Health Insurance project (AMU).

MAIN INDICATORS OF HEALTH EXPENDITURE FROM 2012 TO 2016
OUTLOOK: POLITICAL, INSTITUTIONAL AND ENVIRONMENTAL FACTORS
POSITIVE FACTORS

• Positive attitudes and motivation of decisionmakers to progress towards UHC

• Political will: UHC has been included in the president agenda

• Autonomy of CNAMU

• Existence of CNAMU executive board

• Important efforts to have constructive relationships between the Health sector and Social Health Insurance sector

• Commitment of civil society

NEGATIVE FACTORS

• Political and institutional volatility: Many personell changes within government offces and ministeries

• Insecurity/ terrorism that has led to a slowdown in economic activity and a reallocation of financial resources to security

• Deterioration of the health system

• Suboptimal accountability in public services

• Budget constrains

• Insufficient infrastructure and equipment (2014 the infrastructure availability index was 26.7% at the national level)

 

Source references

• Base de données ENDOS.

• Convention cadre entre le Ministère de la Santé et la CNAMU 2019.

• Enquête STEP.

• IAP/DGEP/MINEFID 2015.

• La loi n°60-2015/CNT portant régime d’assurance maladie universelle auBurkina Faso.

• Les mutuelles sociales au Burkina Faso (2014): Une passerelle pourl’assurance maladie universelle. Online: https://lefaso.net/spip.php?article57994 (accessed 13th April 2020).

• Plan National de Développement Economique Et Social 2016-2020.

• Rapport des comptes nationaux de santé 2016.

• Rapport de l’étude de l’évaluation actuarielle et financière du régimed’assurance maladie2017.

• Stratégie national de financement de la santé pour la couverturesanitaire universelle (SNFS-CSU) 2018-2030.

• WHO NHA database.

• World health organization reports.

 

This card was created in friendly collaboration with Dr. Aloys ZONGO – MD, MBA, MPH, Health Economist - medical specialist in public health and health economics.

National UHC Dynamics Card as PDF

 

A complete overview of the UHC process in Burkina Faso can be found in the attached print version of the card.