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The implementation of cost recovery and the unequal distribution of healthcare services between urban and rural areas explain the reduction in access to healthcare in Burkina Faso. To face this challenge, it is necessary to reconsider the manner in which healthcare districts are financed and to reduce household's contribution to a level compatible with the ability to pay for the majority of the population. Without this change, the system will continue to generate severe social inequalities as patients will seek services in the private sector or among traditional practitioners, causing the public system to decline further and finally offer fewer healthcare services and resources.