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This first post for Global Health Check reviews recent evidence on the impact of removing user fees for mothers and children in Sierra Leone one year after the policy was first introduced. To read the post online visit Global Health Check:
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Here is the first post, on our exciting new platform:
*One year on: the impact of removing health care user fees in Sierra Leone
While there are still some commentators who seem stuck on the question of whether removing fees for health care in poor countries is a good idea at all - thankfully there are others who have moved on to the much more critical question of not whether this should happen - but how.
The recent World Health Report on Health Financing for Universal Coverage leaves no doubt that user
fees are a bad idea. In the Director General’s own words, they constitute 'by far the greatest obstacle
to progress' on the path to universal access.
Learning how to successfully remove fees is best done by looking at those countries that have made that bold step forward. The introduction of free care for pregnant women and children in 2010 in Sierra Leone – a post-conflict nation with a crumbling and severely under-resourced health system and one of the highest rates of maternal deaths in the world - provides very relevant lessons for the numerous other low-income countries facing similar challenges.
READ THE REST OF THIS POSTING ONLINE; ADDRESS ABOVE.
Health Policy Advisor
Development Finance and Public Services Team Oxfam GB
AFRO-NETS, an e-forum on health research and development in Africa, is moderated by an expert, and hosted by the FHI360-SATELLIFE Center
for Health Information and Technology (www.healthnet.org)
This is response by Peter Burgess to this message:
I am glad to see this initiative. A good dialog about important matters is a step in the right
direction ... but what are important matters? I argue that the purpose of any economic activity,
including academic study and dialog is to improve quality of life, but my impression of the modern
world is that most resources are actually allocated to profit and self-serving wealth creation, and
the society at large 'be damned'. I refer to this as the 'capitalist market economy' which has no
ability to do anything except what is profitable, when what we need is a 'value market economy' where
resources get allocated to economic activities that do the most to add value, satisfy critical needs
and improve quality of life.
In the case of the health sector, there has been wonderful progress in the science, but the sector is
in disarray when it comes to the application of the science in an affordable cost effective way to those
that need health services. There are dysfunctionalities at both the rich end of the sector (USA for
example) and at the economic 'base of the pyramid' (BOP). I have been critical for years about the
management information used within the health dialog and specifically the lack of cost accounting
information on one side and the lack of specific health impact on the other.
Observing socio-economic development over a period of several decades I have concluded that performance
is a function of place as well as the specifics of the intervention. I am on record that there could be
a tenfold improvement in performance if interventions were optimized to suit the location ... and of
course there need to be place specific data to keep track of this.
I will follow the Global Health Check ... it might be interesting
September 15, 2011
|The text being discussed is available at