User fees abolition policy in Niger : comparing the under five years exemption implementation in two districts
Date
2010
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Publisher
Elsevier
Abstract
Objective: Analysis of the implementation process for a national user fees abolition policy
aimed at children under age five organized in Niger since October 2006.
Methods: This was a study of contrasted cases.Twodistricts were selected, Keita and Abalak;
Keita is supported by an international NGO. In 2009, we carried out socio-anthropological
surveys in all the health facilities of both districts and qualitative interviews with 211
individuals.
Results: Keita district launched the policy before Abalak did, and its implementation was
more effective. The populations and the health workers of both districts were relatively
well aware of the user fees abolition. Both districts experienced significant delays in the
reimbursement of treatments provided free of charge in the health centres (9 months in
Keita, 24 months in Abalak). The presence of the NGO compensated for the State’s shortcomings,
particularly with respect to maintaining the drug supply, which became difficult
because of payment delays. In Abalak, district officials reinstated user fees.
Conclusions: The technical relevance of user fees abolition is undermined by the State’s lack
of preparation for its funding and organizational management.
Description
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Journal Article (peer-reviewed)
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Keywords
ABOLITION, USER FEES, EXEMPTION, NIGER, EQUITY, HEALTH POLICY, CHILD HEALTH, NON-GOVERNMENTAL ORGANIZATIONS, AFRICA
Citation
Ridde, V., Diarra, A., & Moha, M. (2011). User fees abolition policy in Niger: Comparing the under five years exemption implementation in two districts. Health Policy, 99, 219-225. doi:10.1016/j.healthpol.2010.09.017