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- W2182410357 abstract "1. The Bamako Initiative, implemented in varying degrees in half of the countries of Sub-Saharan Africa since the late 1980s, has shown that organized communities can help sustain local public health services, not only by contributing resources but also by exerting power over the management and delivery of services. Experiences in Benin, Guinea and Mali, of communities organizing themselves to help run and finance primary health services, have strengthened the delivery of public services by establishing a sustained partnership between the state and organized civil society groups. The action of communities complements, and sometimes substitutes for, the action of overextended states with poor institutional capacity, and stagnant and/or unpredictable financial resources. The available public infrastructure has been matched to the availability of resources in the household, with the proviso that household contributors can have a say over the running of these services. 2. Significant results have been achieved in these countries in terms of sustained health care availability for the poor, even with a relatively weak voice from the poor in the community. Client power has been organized from the top down; however, locally generated resources are owned by community associations and have been used to improve the quality of services, particularly ensuring the supply of essential drugs. During the more than 10 years of implementation in these three countries, communitybased services restored access to primary but also to secondary professional health services for more than 20 million people, raised and sustained immunization coverage, increased the use of services among children and women in the poorest quintile, and led to a sharper decline of mortality in rural areas compared to urban areas in both Guinea and Mali. There was almost no change in female schooling levels over this period." @default.
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- W2182410357 date "2003-01-01" @default.
- W2182410357 modified "2023-10-18" @default.
- W2182410357 title "Increasing clients' power to scale up health services for the poor: THE BAMAKO INITIATIVE IN WEST AFRICA Background paper to the World Development Report" @default.
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