Health sector reforms in sub-Saharan Africa: lessons of the last 10 years

Gilson, Lucy; Mills, Anne

doi:10.1016/0168-8510(95)00737-d

Cited by 131 publications

(97 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In areas of intense transmission, this will include regular, intermittent prophylactic treatment of high-risk groups such as infants and pregnant mothers. To achieve this, health delivery systems will have to be vastly improved, especially in most of tropical Africa (77), and this will involve fundamental rethinking at many levels. The issues of near-the-home versus health facility-based treatment, public versus private channels of health care delivery, and interactions between governments and funding bodies, are all under active discussion between national governments and international and other agencies interested in health care delivery (137).…”

Section: Current Global Approach To Controlling Malariamentioning

confidence: 99%

Evolutionary and Historical Aspects of the Burden of Malaria

2002

View full text Add to dashboard Cite

Malaria is among the oldest of diseases. In one form or another, it has infected and affected our ancestors since long before the origin of the human line. During our recent evolution, its influence has probably been greater than that of any other infectious agent. Here we attempt to trace the forms and impacts of malaria from a distant past through historical times to the present. In the last sections, we review the current burdens of malaria across the world and discuss present-day approaches to its management. Only by following, or attempting to follow, malaria throughout its evolution and history can we understand its character and so be better prepared for our future management of this ancient ill

show abstract

Section: Current Global Approach To Controlling Malariamentioning

confidence: 99%

Evolutionary and Historical Aspects of the Burden of Malaria

2002

View full text Add to dashboard Cite

show abstract

“…There is extensive literature on the impact of user fees in low-to-middle income countries, 1,[3][4][5][19][20][21][22] and the subject of their removal, particularly in Africa, is now a heavily debated issue. The findings of the various studies reported in this paper show that in contexts where poverty is widespread, user fees represent a major obstacle to the use of essential health services and exacerbate impoverishment.…”

Section: Discussionmentioning

confidence: 99%

“…Concerns over equity were raised early on, 3,4 and many health systems appear to have relied too heavily on the financial participation of users, compromising healthcare access and living standards. [3][4][5] In the course of evaluating its programmes, Médecins sans Frontières (MSF) has conducted a number of studies in various countries [Burundi, Sierra Leone, Democratic Republic of Congo (DRC), Chad, Haiti and Mali] to determine the degree of exclusion from primary health care and the underlying reasons for this exclusion. 6 Across these contexts (some stable, some in conflict and post conflict, and despite differences in the programmes) some common patterns have emerged regarding user fees and the impact of reduced payment systems for health services.…”

Section: Introductionmentioning

confidence: 99%

No cash, no care: how user fees endanger health—lessons learnt regarding financial barriers to healthcare services in Burundi, Sierra Leone, Democratic Republic of Congo, Chad, Haiti and Mali

Ponsar

Tayler‐Smith

Philips

et al. 2011

International Health

View full text Add to dashboard Cite

“…[41,42] Furthermore, with the current poor revenue generation for financing health care delivery by these charges, the situation in the region is compounded by poor community participation in setting up these fees. [44,45] Several authors have adjudged the implementation of these as poor in that these charges are imposed on the community by governments and other constituted authorities with little or no prior consultation of the populace.…”

Section: Resource Mobilization and Cost Recoverymentioning

confidence: 99%

The Impacts of User Fees on Health Services in Sub-Saharan African Countries: A Ctirical Analysis of the Evidence

John¹

2013

AJPHR

View full text Add to dashboard Cite

The momentum towards achieving the United Nations Millennium Development Goals re-invigorated concerns around sustainable health care financing and the adequacy of the financing arrangements in many lowresource settings. Accordingly, this necessitated the institution of user-fees as part of health financing reform in many countries in sub-Saharan Africa. These fees are charges levied at the point of service with the intent of reducing 'frivolous' consumption of health services, increasing the quality of services available and at the same time increasing coverage and utilisation of services. Likewise, as a 'decisive' policy to cushion the existing challenges facing health care financing in the region, a critical assessment of the assertions of proponents of user fees who use the principle of cost recovery and revenue mobilization to drive the concept of rational utilization, efficiency and equitable distribution of health care services is often exaggerated. As it were, the available evidence suggests that user fees alone will not likely accomplish equity, efficiency, or the sustainability objectives in health services in the region. What is critical is that user fees should be linked to the broader package of financing -such as insurance coverage-and with a view to averting any form of equity danger that may thus arise.

show abstract

Health sector reforms in sub-Saharan Africa: lessons of the last 10 years

Cited by 131 publications

References 44 publications

Evolutionary and Historical Aspects of the Burden of Malaria

Evolutionary and Historical Aspects of the Burden of Malaria

No cash, no care: how user fees endanger health—lessons learnt regarding financial barriers to healthcare services in Burundi, Sierra Leone, Democratic Republic of Congo, Chad, Haiti and Mali

The Impacts of User Fees on Health Services in Sub-Saharan African Countries: A Ctirical Analysis of the Evidence

Contact Info

Product

Resources

About