Free healthcare provision with an NGO or by the Malian government - Impact on health center attendance by children under five
2013; Institut Veolia Environnement; Linguagem: Inglês
ISSN
1867-139X
AutoresRolf Heinmüller, Youssouf Aly Dembélé, Guillaume Jouquet, Slim Haddad, Valéry Ridde,
Tópico(s)Global Health Care Issues
ResumoThe provision of free healthcare is increasingly advocated as a way to improve access to health services for vulnerable population groups. However, decision makers are still short of factual data about the effects of payment exemptions (free provision) where they have already been introduced, and on the impact of different forms of implementation in French-speaking countries of West Africa. In the South of Mali, two types of free healthcare for children under 5 have been introduced : i) initially, a partial exemption, covering only the rapid diagnosis and treatment of malaria, and ii) subsequently total exemption for all primary healthcare. The partial exemption was first implemented by an NGO in a single district, then scaled up by the Ministry of Health on a nationwide scale. Following the partial exemption, health center attendance increased from 0.3 annual consultations per child, to 0.5, and then to 1.8 when total exemption was introduced. The rises in attendance were immediate and lasting for all health centers, whether implemented by the NGO or by the government. Attendance during the rainy season was multiplied by 1.5 after the government-organized partial exemption. Statistical analysis shows that if the government alone (without NGO) were to bring in 100 % free healthcare for children, it could increase health center attendance by a factor in the order of 4.
Referência(s)