Objectives: This study aimed to analyse, at national level, the effects of the free healthcare policy for children on the use of health services by children under five in Burkina Faso. We hypothesized that this policy has led to an immediate and sustained increase in the use of health services for these children in the country.

Setting: We conducted a controlled interrupted time series. Monthly data at district level, spanning from January 2013 to December 2018 and corresponding to 72 monthly data points (39 before and 33 after), were extracted from the Burkina Faso National Health Information System. The analysed dataset included data from all the 70 health districts of the country.

Participants: The study consisted of aggregated data from children under five as the target for the policy with children aged between 5-14 years old as control group.

Intervention: The intervention was the introduction of the free healthcare policy for women and children under five years from April 2016.

Outcome: The primary outcome was the mean monthly rate of health services visits by children

Results: Among the children under five, the rate of visits increased of 57% (IRR= 1.57; 95% CI=1.2 to 2.0) in the month immediately following the launching of the free healthcare policy. An increase in the rate of health facility visits of 1% (IRR=1.01; 95% CI=1.0 to 1.1) per month was also noted during post-intervention. Compared to the control group, we observed an increase of the rate of visits of 2.5% (IRR=1.025; 95%CI= 1.023 to 1.026) per month.

Conclusion: Findings suggest that the free healthcare policy increased the use of health facilities for care in Burkina Faso immediately after the implementation of the policy with a small increase in the rate overtime. Strategies to maintain the policy effect over time are necessary.

Monthly data were retrospectively extracted from the National Health Information System from January 2013 to December 2018. All the data were extracted in May 07–30, 2021 and updated on May 05 –12, 2022. The dataset included observations on 39 months for the pre-intervention period and 33 months for the post-intervention period for all 70 health districts in the country.

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