This summary presents the results of a study carried out in Burkina Faso on social representations of illness and their implications for universal health coverage. The populations surveyed sometimes attribute illness to sacred, divine or mystical causes, and prefer traditional or religious remedies or self-medication before or in parallel with formal care. These recourse trajectories do not necessarily follow a fixed chronology, but depend on convictions, geographical and financial access, and the results of first recourse. The inadequacies of the formal healthcare system – perceived quality of pharmaceutical products, side-effects, lack of water, lack of trust in certain agents and structures – reinforce referral to other care channels. Expenses linked to traditional and religious care can be high (travel, stays, services, sacrifices) and are not necessarily recognized in the usual indicators of healthcare expenditure. In the absence of formal solidarity mechanisms, communities activate endogenous forms of financial and social mutual aid to support the sick. The study recommends adopting an approach centered on people’s needs and expectations, recognizing and organizing traditional and complementary medicine, and fostering community empowerment. It also calls for a negotiation between modern care and community practices, in order to improve public support, accountability and the consideration of real expenses, beyond mere infrastructure and insurance mechanisms. Taking into account community spending and endogenous mechanisms will improve the measurement of real financial commitments and reinforce more inclusive accountability to local decision-makers.