Failure of the process of medicalization of health and social promotion centers in Burkina-Faso

Abstract

Burkina Faso is committed to transforming health and social promotion centers (HSPC) into urban medical centers (UMC). The aim was to improve healthcare provision by decentralizing access to medical doctors. At the end of the project, the objectives set had not been achieved. This study analyzed the implementation process in order to identify the reasons for this failure. We conducted a cross-sectional qualitative study with various key players in the healthcare system involved in implementing the project in the Hauts-Bassins and Centre regions. The interviews were semi-structured. These interviews were transcribed into verbatims and analyzed using NVIVO version 14 software. A total of 17 people were included in the study for the 04 selected UMC, including 01 from the Ministry of Health, 02 project participants, 03 regional health directors (RHD), 03 chief district medical officer (CDMO), 04 general practitioners and 04 head nurses (HN). The project’s underlying causes were the achievement of the Millennium Development Goals (MDGs), decentralization and improved healthcare provision. The project benefited from strong political impetus. The implementation process encountered difficulties linked to underestimated costs, disbursement of funds and the absence of a feasibility study. There are no specific indicators to assess UMC performance. There has been no evaluation of this reform, but the balance sheet showed that 41 (HSPC) had been transformed out of the 286 planned. This project, as implemented, did not achieve its objectives. It draws attention to the importance of following procedures when carrying out projects.