Care-Seeking for Fever for Children Under the Age of Five Before and After the Free Healthcare Initiative in Burkina Faso: Evidence from Three Population-Based Surveys.

Abstract

BackgroundIn 2016, a free healthcare policy (FHP) was implemented in Burkina Faso for children under the age of five. In our study, we aimed to determine the prevalence of care-seeking for a fever in children under the age of five before and after the implementation of the FHP and to analyze the determinants of not seeking care under the FHP.MethodsThe data of three nationally representative surveys were used to evaluate the trends of the prevalence of care-seeking. We performed a modified Poisson regression using a generalized estimating equation to determine the factors associated with not seeking care.ResultsThe prevalence for care seeking increased from 57.5% (95% CI, 54.2–60.8) in 2014 to 72.3% (95% CI, 68.1–76.2) in 2017. Children from the poor quintile were less likely to seek care when compared to children from the poorest quintile (prevalence ratio (PR) = 0.7 (95% CI, 0.5–0.9)). Caregivers who did not have messages regarding malaria in the past six months were more likely not to seek care (PR = 0.8 (95% CI, 0.7–0.9)). Caregivers of children aged 36–59 months were more likely not to seek care compared to those aged <12 months (PR = 1.6 (95% CI, 1.2–2.1)). Children from the Boucle du Mouhoun region (PR = 1.9 (95% CI, 1.2–3.2)) and the Centre-Est region (PR = 1.9 (95% CI, 1.2–3.0)) were more likely not to seek care compared to children from the Sud Ouest region.ConclusionOur study showed an increase in the prevalence of care-seeking after the implementation of the FHP. Even if this is encouraging, these findings highlight the critical importance of non-financial barriers to care-seeking. Maintaining FHP and tackling the barriers should be considered by policy makers to increase care-seeking.