From unintended to undesirable effects of health intervention : the case of user fees abolition in Niger, West Africa; case 16
Date
2010
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Publisher
Guilford Press, New York, NY, US
Abstract
A case study of an evaluation carried out in Niger describes the situation in which evaluators uncovered effects the client had not anticipated in the evaluation design, but which ultimately helped the client improve the intervention. The intervention consisted of abolishing user fees for deliveries and prenatal consultations in order to increase financial accessibility to health care. The changes provoked unexpected reactions from health care workers and the population, such as users developing strategies for hoarding medicines, and nurses selling (free) healthcare booklets due to an increased workload. Uncovering of these unanticipated, and sometimes illicit effects was not envisioned by the client.
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Case Study
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Keywords
HEALTH, NIGER, WEST AFRICA, CASE STUDIES, FEES ABOLITION