La charge de travail des agents de santé dans un contexte de gratuité des soins au Burkina Faso et au Niger* Heath staff workload in a context of user fees exemption policy for health care in Burkina Faso and Niger

User fees exemption policy supported by NGOs in Burkina Faso and Niger resulted in a higher utilization of health services in primary health care facilities. We conducted a survey in 2 health districts in Burkina Faso and Niger in 2011. The study objective was to assess whether the higher utilization associated with the user fees exemption policy, may result in an overload for health staff at the front line in health facilities. The WHO’s recommended WISN method was used to compute a ratio of actual/required staff using a comparative study with 4 control facilities and 4 intervention sites where the user fees exemption policy was provided by local NGOs in both countries. Overall, 8 primary health facilities both in Burkina Faso and Niger were involved. In Burkina Faso, the ratio was ≥1 in all facilities both control and intervention, i.e. a sufficient staff in facilities. In Niger, 3 out of the 4 intervention facilities in Keita district were found to have a ratio ≤1, i.e. understaffed. In the 4 control facilities, the staff was sufficient with a ratio ≥1. In Burkina Faso, the actual number of staff in facilities appeared enough to face the higher utilization of health services that may follow the user fees exemption policy supported by local NGOs unlike Niger where we found that the actual number of staff was insufficient to face a possible higher utilization resulting from the same policy in intervention facilities. L. Antarou · S. Kouanda Département de santé publique et de biologie médicale, Institut de recherche en sciences de la santé (IRSS), 03 BP 7192 Ouagadougou 03, Burkina Faso V. Ridde (*) École de santé publique de l’université de Montréal, Centre de recherche du Centre hospitalier de l’Université de Montréal (CHUM), 3875 rue Saint-Urbain, Montréal, Québec, Canada (H2W 1V1) e-mail : [email protected] L. Queuille Centre de recherche du Centre hospitalier de l’Université de Montréal (CHUM), 3875 rue Saint-Urbain, Montréal, Québec, Canada (H2W 1V1) *Cet article est une version scientifique et développée d’une courte note publiée dans Afrique Contemporaine, note non révisée par les pairs et ne concernant que le Burkina Faso Bull. Soc. Pathol. Exot. (2013) 106:264-271 DOI 10.1007/s13149-013-0307-8