Strengthening health services for MCH in Africa: the first four years of the ‘Bamako Initiative’

Poverty and user fees for public health care in low-income countries: lessons from Uganda and Cambodia

“…4 One option that policy makers might consider is the removal of the fees charged to users by public health facilities. A key strategy in the 1980s was user fees, 5 which has been widely adopted in low-income countries. However, many studies have shown that the introduction of this policy has rarely been benefi cial to poor people.…”

Governance and basic social services: ensuring accountability in service delivery through deep democratic decentralization

“…One approach to this crisis lay in the greater mobilization of community resources in the development of local health services, recognizing that patients seeking care were already beginning to pay considerable sums of money for treatment of various kinds. This was the situation in which the Bamako Initiative arose in 1987-leading in many countries to a reasonably successful example of voice in ensuring access to affordable essential health services for an increasing proportion of people (Jarrett and Ofusu Amaah, 1992;Mehrotra and Jarrett, 2002). The strategy of the BI is to revitalize public health systems by decentralizing decision-making from the national to the district 278 S. Mehrotra level, instituting community financing and co-management of a minimum package of essential services at the level of the basic health units.…”

An Overview of Changing Agendas in Health Sector Reforms

“…One such was the Bamako Initiative by a group of African countries alarmed by the severe deterioration of their health services, which focused on improving service delivery through community-based financing of basic supplies [11]. This has had mixed results.…”