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Table 4 Synthesis of the results of the transversal analysis for the six countries’ knowledge aggregation process

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
  1. Sources: country case studies.