This note presents the knowledge and perceptions of 85 health system stakeholders in Burkina Faso on equity, efficiency and transparency in the allocation of financial resources to public health structures. Respondents included facility managers, district administrators and hospital administrators. The main findings point to a limited understanding of allocation criteria, a lack of transparency and chronic reimbursement delays linked to the policy of free health care, delegated credits and transferred credits. These shortcomings have weakened the structures’ cash flow, leading to debts, stock-outs of essential inputs and difficulties in paying support staff. Nearly 80% described their financial situation as fragile or very fragile, and 94% reported shortages of medicines in 2024. The majority report insufficient funds, inadequate to real needs; lengthy administrative procedures aggravate local absorption. Between 2019 and 2024, more than half of respondents report a drop in the amounts allocated, a phenomenon accentuated by the security crisis, which increases logistical costs and reduces operational capacity in isolated areas. The lack of information on criteria and the confidentiality of allocated amounts fuel suspicions of local mismanagement. To remedy these problems, the proposed recommendations include securing and simplifying reimbursements, revising criteria towards a logic of equity and need, public transparency of criteria and amounts, and strengthening local capacities as well as monitoring and evaluation systems. These measures are designed to restore confidence.