Since 1988, implementation of the Bamako Initiative (BI) recommendations for community participation in management and financing of health services has improved access to basic services and medications throughout the developing world. However, the ten-year review of the BI found that cost recovery systems had limited access to health and education services for the poorest segments of the population, including the seasonally poor. Can new strategies designed to improve access to community health services also help the poorest, or must specific interventions be designed to help them? The USAID/UNICEF Joint Equity Initiative (JEI) aims to develop practical strategies to improve access to health services by those least able to pay for them.
In Guinea, several innovative programs are attempting to improve access to health care and the quality of services delivered for the general community. Strategies include: creation of community-based mutualist pre-insurance schemes; sliding fee schedules with community participation in identifying the neediest; and village committees with varying degrees of authority for health center management.
Learning Objectives: 1) Participants will learn the significance of equitable access to health care in the context of the Bamako Initiative's emphasis on cost recovery, and understand how interventions to improve access to, and quality of, health services can include measures that benefit those least able to pay. 2) They will also be able to identify methods of evaluating the impact of community health interventions with regard to which sectors of target populations benefit the most, and how the interventions affect those who face financial barriers to access. 3) Participants will be able to articulate at least three practical strategies for modifying interventions so that they improve access to health services by those least able to pay for them
Keywords: Financing, Developing Countries
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Management Sciences for Health, USAID, INICEF
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment with MSH