Paying for the Kasongo hospital in Zaire: a conceptual framework

Criel, Bart; Balen, H Van

doi:10.1093/heapol/8.1.61

Cited by 11 publications

(4 citation statements)

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“…Kisantu has a long history of cooperation with Belgium. In the 1970s and 1980s, it cooperated with other health zones to feed and influence health policies throughout the DRC ( 26 , 27 ).…”

Section: The District Of Kisantumentioning

confidence: 99%

Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity

Stasse¹,

Vita²,

Kimfuta

et al. 2015

Global Health Action

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BackgroundComzmercialization of health care has contributed to widen inequities between the rich and the poor, especially in settings with suboptimal regulatory frameworks of the health sector. Poorly regulated fee-for-service payment systems generate inequity and initiate a vicious circle in which access to quality health care gradually deteriorates. Although the abolition of user fees is high on the international health policy agenda, the sudden removal of user fees may have disrupting effects on the health system and may not be affordable or sustainable in resource-constrained countries, such as the Democratic Republic of Congo.Methods and ResultsBetween 2008 and 2011, the Belgian development aid agency (BTC) launched a set of reforms in the Kisantu district, in the province of Bas Congo, through an action-research process deemed appropriate for the implementation of change within open complex systems such as the Kisantu local health system. Moreover, the entire process contributed to strengthen the stewardship capacity of the Kisantu district management team. The reforms mainly comprised the rationalization of resources and the regulation of health services financing. Flat fees per episode of disease were introduced as an alternative to fee-for-service payments by patients. A financial subsidy from BTC allowed to reduce the height of the flat fees. The provision of the subsidy was made conditional upon a range of measures to rationalize the use of resources.ConclusionsThe results in terms of enhancing people access to quality health care were immediate and substantial. The Kisantu experience demonstrates that a systems approach is essential in addressing complex problems. It provides useful lessons for other districts in the country.

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“…Kisantu has a long history of cooperation with Belgium. In the 1970s and 1980s, it cooperated with other health zones to feed and influence health policies throughout the DRC ( 26 , 27 ).…”

Section: The District Of Kisantumentioning

confidence: 99%

Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity

Stasse¹,

Vita²,

Kimfuta

et al. 2015

Global Health Action

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“…Such cascading systems of charges do exist in a number of countries including Kenya, Indonesia, Namibia, Zambia, and Zimbabwe (Barnum and Kutzin, 1993;WHO, 1994). Criel and Van Balen (1993) reported that these prices structure did indeed move individuals out of hospitals into health centers in Zaire. However, in Zambia and Zimbabwe, hospitals are still overcrowded and health centers still underutilized.…”

Section: Improving Health Statusmentioning

confidence: 99%

Strategies for Pricing Publicly Provided Health Services

Gertler

1999

Policy Research Working Papers

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“…It is likely to succeed only if a number of structural and organizational changes are met: for instance, the existence of a real dialogue between health service and community, the organization of 'defaulter tracing' with the possibility of carrying out home visits, the implementation of a continuity 'friendly' fee system etc. (Criel and Van Balen, 1993). Integration of care, in itself a condition for having holistic care implies a good knowledge of the patient and of his social environment, an appropriate individual information system, and so on.…”

Section: An Integrated Health Systemmentioning

confidence: 99%

Principles of health infrastructure planning in less developed countries

Unger

Criel

1995

Health Planning & Management

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This article proposes a number of key principles for health infrastructure planning, based on a literature review on the one hand, and on a process of internal deduction on the other. The principles discussed are the following: an integrated health system; a thrifty planning of tiers within that health system; a specificity of tiers; a homogeneity of the tiers' structures; a minimum package of activities; a territorial responsibility and/or an explicit and discrete responsibility for a well-defined population; a necessary and sufficient population basis; a partial separation of administrative and public health planning bases; and, finally, rules for a geographical division and integration of non-governmental organizations. The definition of two strategies, primary health care and district health systems, is also revisited.

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Paying for the Kasongo hospital in Zaire: a conceptual framework

Cited by 11 publications

References 0 publications

Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity

Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity

Strategies for Pricing Publicly Provided Health Services

Principles of health infrastructure planning in less developed countries

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