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.

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]