Will patients be better off with a decentralised basic health service? : effectiveness of a decentralizing basic health service in Burkina Faso
Document type: report
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Abstract:
In Burkina Faso basic health services are progressively being decentralized to municipalities after the local elections of 23 March 2006. This study analyses the effect of the relationship between four key actors (policy makers, service providers, beneficiaries, and donors) on health service delivery. It was found that the mechanisms of accountability were heavily out of balance. The position of the beneficiaries is especially weak, for they lack information, they do not participate in decision making, and their formal structure (the COGES) is practically powerless and not motivated. They have few means to express their satisfaction, or to be heard in general. Finally, they suffer from corruption. Putting it briefly: they have no ‘voice’ and no ‘client power’. Significant capacity strengthening, creation of new structures, and changing behaviour of many actors will be needed. This will take time, probably more than the nine years till 2015. If no corrective arrangements are taken, the poorest patients risk paying the price.
Authors:
Wal, B. van der
,
Sika, J.M.
,
Congo, A.
,
Zone, K.
Series Title:
SNV publications
Country:
Burkina Faso
Category:
Research
Serial number:
H0702-10
Keywords:
health services
,
decentralization
Language:
eng
Organization:
SNV - Netherlands Development Organisation
PAGE:
32
Place:
The Hague
Publisher:
SNV Netherlands Development Organisation
Year:
2007
Region:
Africa South of Sahara
,
West Africa
Right:
© 2007 SNV
Subject:
Health and Nutrition
Title:
Will patients be better off with a decentralised basic health service? : effectiveness of a decentralizing basic health service in Burkina Faso