Burkina Faso

The first title of the Constitution titled "Fundamental rights and freedoms" is structured around four chapters looking at civil rights and duties, political rights and duties, economic rights and duties and social and cultural rights and duties. Under this last chapter (chapter 4) the right to health is first referred to under article 18 along with the recognition of other rights e.g. right to education, drinkable water, sanitation, social security, housing, energy, sports etc. It is also specifically referred to under article 26 stating that the right to health is recognized and that the State works towards its promotion. Article 29 enshrines the right to a clean environment.

Under the Second title of the Constitution, Burkina Faso is a democratic, unitary and secular State and is a republic (article 31). Institutions include the President (title IIII), the Government (title IV), the Parliament (title V). The judicial power is addressed in title VIII while title IX relates to the High Court of Justice. An Economic and Social Council is set with a consultative role on questions raised by the President or the government (article 141). There is a constitutional council (title XIV), and a Supreme Authority for State Control and the fight against corruption (title XIV quater). Other institutions are cited in the Constitution (non-exhaustive list).

The Universal Health insurance scheme is mandatory to any person domiciled in Burkina Faso and to any individual or legal entity (public or private) employing at least one salaried worker (art.6). It covers the individuals subject to the law and their dependent family members as well as indigent persons (art.7).

The universal health insurance scheme instituted by the law, guarantees coverage of the costs of curative, preventive, promotional and rehabilitative healthcare services (art.11). It covers a series of illness which are based on a delimit list of care defined by Ministerial Decree (art.12) . The universal health insurance scheme guarantees direct payment of all or part of health care cost. A remainder have to be paid by the insured person, where applicable (article 13). Beneficiaries of the universal health insurance scheme shall retain free choice of practitioner and of the health establishment, pharmacist and supplier of the appliances and medical devices prescribed for them (art.15).

The law creates a body called "Organisme de Gestion", whose purpose is to manage the universal health insurance scheme (art.38).

The law defines reproductive health as the state of general physical, mental, moral and social well-being of the human person in all matters relating to the reproductive system, its functions and its operation (art.2).The law further provides a list of reproductive health care and services organized across women health, children health, youth health; men health as well as family planning among other aspects. The law also includes as a component of the reproductive health the prevention against sexually transmitted infections and against harmful traditional practices (art.7).

The law has a chapter on rights and duties regarding to reproductive health which includes, among other rights, the right to reproductive health (including for children and adolescents) without discrimination (article 8), the right for every individual and every couple to benefit from the best possible healthcare and not to be exposed to practices that are harmful to their health (art12). The same chapter also states the right to every woman to a birth assisted by a qualified health care professional (art.12); as well as the right to protection from torture and cruel, inhuman or degrading treatment of the body in general and of the reproductive organs in particular (art13).

The legislation authorizes abortion in three specific cases: (1) When the continuation endangers the life and health of the pregnant woman. (2) At the woman's request, when the pregnancy is the result of rape or an incestuous relationship. (3) When there is a strong probability that the unborn child will suffer from a particularly serious condition at the time of diagnosis (art.21).

The first part of the Public Health Code ("General Provisions") highlights the priority given to primary care (article 4). It further provides fundamental principles guiding the action of the national health systems which include, among others, the harmonious development of the public and private sectors, the integration of health planning into the overall process of national socio-economic development, multi-sectoral and interdisciplinary approach to the implementation of health programmes, decentralization and prioritization of health services and self-empowerment of the community and individuals and their participation in the organization, planning, implementation and evaluation of health programmes (article 5). The responsibility of the State for health protection and promotion and for service delivery is recognized (article 6). It is further provided that health care and services are provided, on a fee-for-service basis, in the private for-profit sector while a contribution is required from the population in both the public and the private not-for-profit sectors (article 7).

The second part titled "Public health protection and promotion" covers a broad range of issues such as, water and air pollution, hygiene, sanitation, fight against epidemics and endemics, family and child health protection, protection of workers' health, protection of the disabled and the elderly, mental health protection, nutrition and consumer health protection and border control.

The third part "Health professions and their legal status" governs the practice for medical professions and medical auxiliaries (including doctors, dentists, midwives, nurses ), pharmacists and pharmacy assistants and medical biologists. Highlights from this part include the creation of a national order of physicians, which must include all doctors licensed to practice in Burkina Faso (art. 137) and a national order of dental surgeons, which must include all dental surgeons authorized to practice in Burkina Faso (art.138). In addition to those orders, the law establishes a national order of midwives which brings together all midwives entitled to practice in Burkina Faso (art 139) as well as a national order of nurses which includes all nurses authorized to practice in Burkina Faso (art. 140). The Code specifically recognizes traditional medicine in Burkina Faso (art 141) and its practitioners.

the fourth part "Pharmaceutical products, other products and traditional pharmacopoeia" addresses among other things the preparation and wholesale of pharmaceutical products (e.g., manufacturing and marketing authorization, advertising regulations). The Last part includes the Final Provisions.

The Decree defines the heath benefit package as all the healthcare procedures, goods and services covered by the management bodies (art.2).

The heath benefit package includes: a) general medical procedures and medical and surgical specialties ; b) nursing procedures; c) care relating to pregnancy, childbirth and the post-natal period; d) procedures and care related to hospitalization and surgery; e) emergency oral and dental care; f) medical biology tests; g) radiology and medical imaging procedures; h) functional explorations; i) outpatient and inpatient healthcare products; j) functional rehabilitation and physiotherapy; k) medical transport of patients to health establishments; l) approved traditional medical consultations (art.3)

Services excluded from the heath benefit package are: a) activities covered by the Expanded Immunization Program; b) eyewear; c) travel vaccines; d) health promotion, prevention, screening and social care activities under the responsibility of the Ministry of Health; e) diseases covered by specific programs or funding by the State or by national and/or external technical and financial partners. The list of these diseases and programs is set by joint order of the Minister of Health and the Minister of Social Protection; f) healthcare goods and services used to treat epidemics declared by the competent authorities and covered by the Ministry of Health; g) plastic and cosmetic surgery, with the exception of medically required reconstructive surgery and maxillofacial orthopedics; h) healthcare services provided as part of alternative medicine. E) Complementary examinations carried out outside national territory. (art.4)

The Decree settled free screening and treatment for cervical and breast cancer for women in Burkina Faso (art.2). Those services are available in all public and contracted health facilities in Burkina Faso (art.3). Regarding Private health facilities, they could be part of this organization upon an agreement with the Ministry of Health (art.4).

The list of treatments concerned, by level of care, is set by an order from the Ministers of Health and Finance (art.6).