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Towards Universal Health Coverage in Benin: obstacles to using rehabilitation services by disabled people

par Assogba, Corneille Tolofon;Godonou, Elie-Tino;Labat, Aline
Référence European Congress on Tropical Medicine and International Health(12: 8/09 - 01/10/2021: Virtual from Bergen Norway), TM & IH. Tropical medicine and international health, TM & IH. Tropical medicine and international health (26), 303
Publication Publié, 2021-09-01

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Résumé :

Context: Rehabilitation care is essential after the onset of a disability, and help to improve Disabled People's (DP) functional autonomy. In Benin, access to care is not guaranteed for all, and very few of the DP who access it manage to complete care. For the effectiveness of UHC, it is important to know the factors that influence their use of rehabilitation care.Methods: This cross-sectional study with an analytical aim, carried out in 2019, included 318 DP received in rehabilitation in 2018 at the hospital and/or in a community-based rehabilitation district. Interviewed by questionnaire, the DP presented cerebral palsy (37.4%); severe hemiplegic sequelae (30.8%); spinal cord injuries (11.3%); and amputations (11%). Single and multiple logistic regressions were performed to identify significant factors influencing the optimal use of rehabilitation care, defined as the ability to complete rehabilitation treatment as planned and without interruption.Results: Over the 228 DP who received care at hospital, 46.0% had a suboptimal use of rehabilitation care and only 17.2% benefit from a healthcare coverage measure (insurance or other measures). The significant factors that influence the optimal use of rehabilitation care are: age (OR:0.67, p=0.034), level of education (OR:1.47, p=0.007), coverage of care (OR:0.29, p=0.002), socio-economic level (OR:0.45, p<0.0001), dependence to go to care (OR:2.58, p=0.004), level of dependence (OR:1.86, p=0.001), to benefit of an appropriate/personal mean of transport to go to care (OR:2.05, p=0.015), and postponement of care for financial reasons (OR:4.55, p<0.0001). After adjustment for the other variables, the multiple regression only shows as significant: the socio-economic level (OR:0.46, p=0.022) and the postponement of care for financial reasons (OR:4.93, p<0.0001).Conclusion: In this study, too few DP benefit from healthcare coverage. The impact of the socio-economic level being important and noted, the Beninese authorities have some elements from this study to better address this problem.