Impact of subsidised deliveries on the rate of very early neonatal death and intrapartum death in a district of Burkina Faso: a quasi-experimental study

Abstract

No study has been done to evaluate the association between policy to reducing financial barriers to obstetric
care in low-income countries and the rate of very early neonatal death or intrapartum death (fresh stillbirth).
The objective of this study was to determine the impact of the national subsidy on the early neonatal
or intrapartum death in a district hospital. We used a quasi-experimental approach by comparing the
number of early neonatal or intrapartum death between 24 months before and 24 months after the introduction
of the subsidy. We used a segmented Poisson regression with robust variances. In total, 40 and
42 early neonatal death or fresh stillbirth of 2 500 g or plus took place in the district hospital respectively
before and after the subsidy introduction. Immediately after its introduction, the policy subsidy was associated
with non-significant decrease by 9 fresh stillbirth or early neonatal death per 1 000 births of 2 500 g
or plus, that is 41% relative decrease. This decrease remained non-significant for 24 months after the
introduction of policy. Others studies are needed to confirm these results and to explore a possible heterogeneity
of the results between health centers.