Impact of the free healthcare policies in Burkina Faso: underscoring important nuances

The article recently published by Aye et al. (2024) in Health Policy and Planning is a major contribution to understanding the medium-term (5 years) effects of the free healthcare policy introduced in 2016 in Burkina Faso. The study makes rigorous use of interrupted time series with a nonequivalent control group and presents a wealth of information on the methodology used. Remarkably, numerous sensitivity analyses were conducted to strengthen the credibility of the results and limit the risk of bias. Three salient conclusions are presented: (I) free healthcare had no effect on the proportion of pregnant women who gave birth in a health center, either immediately or after 5 years; (II) free healthcare led to an immediate and significant increase in the rate of consultations for children <5 years of age; and (III) after this immediate increase, free healthcare led to a gradual decrease in the rate of consultations for children <5 years in the medium term. We believe it is essential to highlight some important nuances regarding these conclusions and highlight some methodological issues.