Community health and its failures in the Kayes region of Mali
Abstract: This article looks at advances and failures of community health in Mali. The work is based upon a study undertaken on the ground with community health bodies and their users in the Kayes region. The results show that despite the services provided by community health, this can only be a real tool for health under certain conditions, mainly involving the role of public bodies in regulating health centres and rebalancing their unequal resources.
The evaluation of an experiment in healthcare user fees exemption for vulnerable groups in Burkina Faso
Abstract: The African Union and United Nations agencies requested that children under five years and pregnant women be exempt from healthcare payment at the point of service. Indeed, this payment method is a financial barrier to healthcare access that the most vulnerable populations cannot overcome. Since Burkina Faso had not yet implemented such a policy, an experiment was undertaken starting in 2008 in two districts of the Sahel region in order to produce evidence.
The feasibility of community-based private medical practice in Africa and Madagascar
Abstract: An ever-growing number of doctors are being trained at the Faculties of Medicine of French-speaking Africa and Madagascar, and yet the shortage of general practitioners in rural and periurban areas continues to be a cause for concern, even though there are more unemployed young medical graduates than ever.
A public/private partnership experiment in the area of social health protection in Tanzania
Abstract: An NGO, the Centre International de Développement et de Recherche (CIDR, International Centre for Development and Research), supported a network of mutual health organisations in the Mbozi district of the Mbeya region in Tanzania. The target population were households living in rural areas from the informal sector that had access to the services of a private religious hospital.
Free healthcare provision with an NGO or by the Malian government
Abstract: The provision of free healthcare is increasingly advocated as a way to improve access to health services for vulnerable population groups. However, decision makers are still short of factual data about the effects of payment exemptions (free provision) where they have already been introduced, and on the impact of different forms of implementation in French-speaking countries of West Africa.
Solidarity-based financing of medical evacuations to improve access to emergency care, Keita Medical District (Niger)
Abstract: In recent years, a number of African countries, including Niger, have adopted policies abolishing user fees at point of service, targeting categories of people or services. These policies do not take account of geographical and financial accessibility for cases that require medical evacuation from primary to secondary level. This paper documents an experiment illustrating the importance of considering the place of medical evacuation in fee exemption schemes for vulnerable population groups.
The simultaneous introduction of the district health system and performance-based funding: the Burundi experience
Abstract: Burundi recently introduced two fundamental reforms to its health system: a district health system (DHS) and performance-based financing (PBF) of the healthcare facilities.
The authors of this article set out the salient points of a trial simultaneous implementation of DHS and PBF.