An implementation evaluation of a policy aiming to improve financial access to maternal health care in Djibo district, Burkina Faso

摘要: To bring down its high maternal mortality ratio, Burkina Faso adopted a national health policy in 2007 that designed to boost the assisted delivery rate and improving quality of emergency obstetrical neonatal care. The cost transportation from centres district hospitals is paid by policy. worst-off are exempted all fees. objectives this paper analyze perceptions workers, assess how was implemented at level, identify difficulties faced during implementation, highlight interactional factors have an influence on implementation process. A multiple site case study conducted 6 Djibo Faso. following sources data were used: 1) documents (n = 23); 2) key interviews with managers (n = 10), workers (n = 16), traditional birth attendants (n = 7), community management committees (n = 11); 3) non-participant observations centres; 4) focus groups communities (n = 62); 5) feedback session findings 20 staff members. All activities as planned except for completely subsidizing worst-off, some such surveys patients assurance service team aiming improve District perceived implementing because lack clarity topics guidelines. Entering into electronic database long delay reimbursing costs principal challenges implementers. Interactional relations between providers raised. These Strained involved may reduce effectiveness Implementation analysis context financial access care African countries still scarce, especially micro level. strained process effects Therefore, power actors system should be taken consideration. More studies needed better understand low-income countries.