Les enjeux éthiques d'une recherche-action sur une sélection communautaire des indigents au Burkina Faso

Support health care for the poor in Burkina Faso raises several challenges including equity of access to health services. This article presents the results of the evaluation of the ethical dimensions in a participatory action-research initiated in the Ouargaye district (Burkina Faso). This action-research aimed to test the feasibility of a mechanism for the selection and funding of free healthcare for indigent. This is a qualitative study based on semi-structured interviews conducted with 39 stakeholders involved in action-research. The interviews were recorded, fully transcribed and analyzed using inductive analysis. The analysis identified the ethical implications related to the research in the context of vulnerability, gender and power and finally the political and governance dimensions. The results show that questions of justice, power and potential conflicts of interest had taken an important place in the selection process of the indigents. In addition, action-research has helped to strengthen community solidarity toward the poorest and the transfer of knowledge to local communities. Finally, this action-research in a context of vulnerability raises particular ethical issues that are not addressed by the guidelines and frameworks applicable in research ethics. These include the nature of the relationship between researchers and participants as well as their involvement in the identification of problems and solutions.