Burkina Faso health system

Structure

Structure 

The Burkina Faso health system has three sectors:  

  • The public sub-sector,  
  • The private sub-sector and  
  • The traditional sub-sector: 

3 sectors: public sub-sector, private sub-sector and traditional sub-sector:

Public sub-sector:

  • Health districts:

    • First level of contact:

      • 1,606 health and social promotion centres, 123 isolated clinics, 14 isolated maternity clinics and 32 medical centres

      • Minimum package of activities (including malaria)

    • Second level: 45 district referral hospitals/medical centres with surgical units

  • Regional level

    • Hospitals (9)

    • Referral level facilities for district level

  • National level

    • University hospitals (3), national hospital

    • Referral level facilities for regional level

    • Medical training and research

Laboratory network at 120 facilities at all levels

Private Sector 

  • 2013: 78 private healthcare facilities providing hospital care

  • 306 private healthcare facilities providing non-hospital care

  • 693 private dispensing pharmacies and drug stores

  • Mostly in Ouagadougou and Bobo-Dioulasso

Traditional medicine sector

  • MoH recommends that serious cases of illness seen by these practitioners be referred to healthcare facilities 

    • Practitioners will be trained to recognize signs of severe malaria (funded by the state budget)

  • Traditional medicine sector is gradually being incorporated into the health system under the Directorate for Medicine and Traditional Medicine at the MoH.
  • Government budget will support training of traditional medicine practitioners to recognize signs of severe malaria and to refer these cases to the appropriate health facility.

In the public sub-sector, according to the 2020 Statistical Yearbook, the health infrastructure includes five university hospitals at the tertiary level, nine regional hospital centers and one university hospital center at the secondary level, and 2,158 health care establishments at the primary level.  

Private facilities are concentrated in the major cities, with three hospitals at the tertiary level, eight polyclinics at the secondary level, 286 health care establishments at the primary level, plus 593 other health care structures, 243 pharmacies, and 661 pharmaceutical depots. Approximately 30,000 traditional health practitioners work individually in health care offices and herbalist shops. 

The NMCP is in the process of developing a DHIS2-based malaria data repository and accompanying dashboards.  

The health sector has been both directly and indirectly affected by the worsening security situation. Also as of February 28, 2022, the MOH reported that 499 health facilities were affected by insecurity leaving an estimated 1.9 million individuals with restricted access to health care.  

Challenges

Case Management

  • Rectal artesunate not included in pre-referral guidelines

Quality of health information system

  • Data quality and completeness

  • Delayed transmission

  • Excessive workload due to the large number of data collection tools

  • No data on consumption, number of people reached by awareness-raising activities and community data

    • Parallel information system results in duplicate, inconsistent information

Input management

  • Procurement

    • Late deliveries, cumbersome procedures, tight stock levels, lack of financial resources

    • Leads to nationwide stock-outs.

  • Storage

    • Storage and distribution limitations

    • Delivery delays and/or over-stocking

      • Negotiations under way with partners and central purchasing office for essential generic drugs and medical consumables to integrate all products into the national drug distribution system

  • Distribution

    • Procurement challenges 

    • Lack of coordination

Human resources

  • Human capacity constraints

  • Mobile populations lead to delays and shortcomings in implementing activities

  • Supervision of community level workers

MOU with the private sector 

Though the majority of malaria case management occurs in the public sector, the private sector accounted for roughly 5.5 percent of malaria case management nationally in 2018 according to the NSP 2021–2025. To strengthen this portion of case management, the NMCP and the private sector are working to draft a memorandum of understanding (MOU) for effective antimalarial commodity management and reporting in private sector health facilities. The MOU will define the duties and responsibilities of both parties. The most commonly available antimalarial commodities in the private sector are artemether-lumefantrine, dihydroartemisinin-piperaquine, artesunate-pyronaridine, artesunate-amodiaquine, and artesunate sulfamethoxypyrazine-pyrimethamine.[2]