Table 1 The Bamako initiative

Background

The Bamako Initiative (BI) is a policy statement, adopted in 1987 by African health ministers in Bamako, Mali. It was developed in the context of economic crises and negative effects of adjustment programmes in many Sub-Saharan countries. Formulated by UNICEF and WHO, the initiative aimed to promote universal access to primary health care.

Objectives

• Strengthen the management and financing of health care at the local level.

• Promote community participation.

• Improve the supply, management and use of essential drugs.

• Ensure sustainable financing of primary health care units.

Principles

Decentralisation of decision-making to health districts and of financial management to communities; partial cost-recovery through the sale of essential drugs; sufficient funding for primary healthcare by governments; exemption policies for the poorest groups in society; health promotion and a multi-sectorial approach to health care.