In Burkina Faso, out of three million small children, 500,000 do not live to be five years old. The majority of these deaths could be avoided with a more accessible health system. The exemption of payment for health care for all children under five and for expectant mothers is one of the most efficient solutions to allow an extremely poor population to benefit from the health services.

This document describes the experiences of Terre des hommes and the health districts of Tougan and Seguenega, in the implementation of the healthcare user fee exemption policy in Burkina Faso. The various phases of its implementation process, as well as lessons learnt, have been described herein. The document is intended for all who wish to replicate this innovative approach in Burkina Faso or other countries in the sub region.

This approach has multiplied by six the rate of consultations for children under five and reduced by 36 % the costs of consultation and treatment of childhood diseases in health centres, as well as social development in the two pilot districts of Tougan and Seguenega.