In 2016, the government of Burkina Faso decreed free healthcare for pregnant women and children under five in public health facilities. The basket of care covers consultations and intervention procedures, medicines and medical consumables, blood products, additional examinations, hospital stays and medical evacuation in the health system. After eight years of implementation, free healthcare has helped reduce the maternal mortality rate by less than 59%.
Limata Ganamé is a mother of five children, three of whom are still alive. In the health and social promotion center (CSPS) of Bingo, located in sector no. 7 of Ouahigouya where we met her, she is holding a six-month-old baby. Today is the appointment for her child’s routine weighing. After the consultation, the midwife says that her child is doing well. Lady Limata did not pay anything for this.
Before this baby, Mrs. Ganamé lost two children after giving birth. Her story begins in 2014 when she became pregnant for the first time. Due to lack of financial means, she was unable to monitor her pregnancy. I am a housewife, my husband does not work. It was difficult for me to go to a health center to do the consultations or to have enough to buy the medicine (iron) against possible anemia and the antimalarial product. ” she confesses, looking sad. So she dragged the pregnancy out until she gave birth. It was after three days of labor that she finally gave birth at home to a stillborn child.
A few months after this misfortune, she fell pregnant again. The scenario repeated itself. No prenatal consultation (CPN) until the day of delivery which would have prevented the worst. “Just a few hours later, her baby passed away. ” she says, her eyes misty.
History could have repeated itself for Mrs. Ganamé, but the government’s new policy came just in time to get her out of the rut: free healthcare for pregnant women and children under five. “Thanks to this policy, I was able to do my prenatal visits, have products against anemia and malaria. Today, I have three healthy children. The last one was born in December 2023 ” she explains, looking grateful.
Like her, Mrs. Kadidiata Weremy, a refugee, is also a mother of six children. Coming from Mali, she set foot on Burkinabe soil in 2018. This is where I had my last child who is in CP1 this year. I was surprised to see that healthcare is free. At first, I thought it was because of my refugee status. It was only after the fact that I understood that it is a policy put in place by the State. ” she notes.
The policy has been a lifesaver for many women. Indeed, according to data from the 2022 statistical yearbook of the Ministry of Health, the average cost of care during pregnancy is between 1,000 and 22,000 FCFA.
A summary table of healthcare prices before free care
| Health training | Prenatal consultations | Childbirth |
| CSPS | 1 000 | 3 300 |
| CMA | 7 000 | 25 000 |
| CHR/CHU | 22 000 | 52 000 |
CSPS: health and social promotion center
CMA: medical center with surgical unit
CHR: Regional hospital center
CHU: university hospital center
The evolution of consultations and deliveries
Source: 2022 statistical yearbook of the Ministry of Health,
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Free healthcare, a life-saving decision
According to the director of Gender Vision and Coaching, Mrs. Fatimata Sinaré Ouilma, a gender and development specialist, the observation was that women had problems taking care of themselves in terms of health. Some often went to health centers without resources even to ensure weighing which cost 200 FCFA. Something they have to do every month until delivery. If they don’t have money to pay for the consultation fees, they won’t be able to buy tablets to fight anaemia and malaria. “, explains Mrs. Sinaré. However, malaria is the leading cause of death in Burkina Faso. ” This explains the increase in the maternal mortality rate. ” she adds. Free is a wonder for gender expert, Ms. Sinaré. She is especially happy for women in rural areas who are tested in terms of scholarships.
“This decision comes as a breath of fresh air to relieve us and motivate us to follow up on pregnancies correctly. So as soon as labor begins, we immediately go to the nearest maternity ward for delivery. “, confirms Limata Ganamé.
Reduction in maternal mortality
Source: Technical Secretariat for Health Financing Reform (ST/RFS)
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These data from the Technical Secretariat for Health Financing Reform (ST/RFS) show the evolution of the maternal mortality rate. It shows that between 2015 and 2021, there is a drastic decrease of 59%.
And the midwife of the maternity hospital (CSPS) of sector 2 of Ouahigouya, Abdoulaye Ouédraogo noted that to reduce the risks of complications that could lead to the death of the mother after childbirth, the pregnant woman must at least have four prenatal consultations (CPN) as was the case before and take her medication until childbirth. She must be assisted by a health professional during her delivery. ” This significantly reduces the risk of complications. If the patient is well monitored, the risks are minimal. “, confides the health worker. Free care has therefore contributed to increasing the rate of deliveries from 2018 to 2022 and reducing the maternal mortality rate.
For the program manager at the Health and Family Department, Dr. Mathieu Bougma, free care for pregnant women encourages their husbands to accompany them to health centers as soon as they become pregnant. “As soon as they go into labour, they are taken to the maternity ward. There is no need for them to let them drag on until they reach the stage of complications before going there. ” he added.
Patient satisfaction is appreciable. Through a survey conducted between January and March 2024 on 17,839 beneficiaries, they expressed their degree of satisfaction with free health services. The survey focused on reception, confidentiality, hygiene, free policy, treatment received and waiting time. It revealed that overall satisfaction is 100% on confidentiality and 99% for each of the other components, according to data from the free health care newsletter.
This feeling is also shared by Limata Ganamé. Being assisted by a health worker saves us from complications during and after childbirth. I can only hope that it continues,” she insists while welcoming the government’s efforts.
For the Chief Medical Officer of the Ouahigouya health district, Lozé Issa Traoré, this assessment is proven. Thanks to the free service, the number of pregnant women and children from zero to five years old who come for consultations in the health centers has increased. Men not only allow their wives to go to health facilities for pregnancy monitoring until delivery, but they accompany them when the child is sick. Better still, they go there as quickly as possible. These gestures have contributed to reducing the infant and maternal mortality rate,” he insists. And he continues that the measure is truly beneficial for vulnerable families.
Souleymane Porgo, with his Association bonne main, is a member of the Community-Based Organization for Execution (OBCE) in health. This structure is responsible for monitoring state policies on the ground by civil society organizations. He attests that the measure of free care makes ” happy winners “Today, women no longer have to worry about buying a health record, products to combat anemia and prevent malaria, or the cost of weighing and prenatal care. Everything is free. It’s a sigh of relief for families,” confirms OBCE Porgo.
However, he denounces the delay in the reimbursement of invoices by the State. According to him, the management committees (COGES) of health facilities sometimes find themselves unable to renew orders for products, hence the shortages sometimes observed.
Satisfaction rate of 17,839 beneficiaries
Source: Free healthcare information bulletin from the technical secretariat for health financing reform (ST/RFS)
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BIRBA flower