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HIV Services Delivery and Overall Quality of Care and Satisfaction in Burkina Faso: Are There Privileged Patients?

  • 2010
  • Working Paper
Kazianga, H.; Kouanda, S.; Nikema, L.; Rothenbuhler, E.; Over, Mead & de Walque, Damien

Abstract: In Burkina Faso, the number of HIV-positive persons under antiretroviral treatment (ART) quintupled from 2004 to 2007. The effect of the provision of ART and other medical services related to HIV on the quality of care and satisfaction of all, HIV and non-HIV patients is debated, but the evidence is limited. 43 health facilities delivering ART or about to do so were surveyed in 2006. Healthcare quality was assessed by patients’ self-reported satisfaction and a quality index assessing the quality of healthcare practices. Upfront costs and waiting time were evaluated from patients’ report. We performed health facility fixed effects multivariate regressions of healthcare quality, upfront costs and waiting time. We focused on patients’ wealth and whether the purpose of the visit was related to HIV/AIDS. Consulting for HIV-related services, while not more costly to patients, significantly increases the quality of care received and increases substantially the time spent waiting for this upgraded service. The wealth of patients does not affect care quality, but helps in reducing waiting time, in particular for HIV patients. Our finding that patients visiting for HIV services receive on average better quality than others does not imply that HIV services have had a negative impact on other health services, but further investigation using panel data should be conducted to investigate this question. However, we can conclude that it would be desirable for the quality of care in other services to reach at least the level attained in HIV services and the upfront costs to be reduced.

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