From: Transversal analysis of public policies on user fees exemptions in six West African countries
Implementation Component | |
---|---|
Management (S1) | Majority of State financing |
Maintenance of centrally organized financing | |
Multiplicity of reimbursement methods | |
Reimbursement delays and/or stock shortages | |
Almost no implementation guides | |
Lack of support measures | |
Communication (S2) | Communication plans that were rarely carried out, funded or renewed |
Health workers who were given general information but not details | |
Poorly informed populations | |
Monitoring / Evaluation / Coordination (S3) | Almost no monitoring and evaluation systems |
Ineffective and poorly funded coordination systems | |
Community involvement (S4) | Low levels of community involvement |
Patient management and referral (S5) | Incomplete exemption policies |
Partial referral-evacuation systems | |
Actors’ Attitudes | |
Health workers’ motivation and satisfaction (A1) | Objectives that were appreciated |
Dissatisfaction with the implementation | |
Provider–patient relationship (A2) | Specific tensions |
Patients’ satisfaction (A3) | Overall satisfaction |
But still some problems | |
Patients’perceptions on health and on financial access to care (A4) | The financial barrier has been removed but other barriers persist |
Health workers’ coping strategies (A5) | Reorganization of practices |
Service rationing due to lack of reimbursement | |
Overcharging or shifting of resources |