At a 1997 conference on cost recovery in the social sectors, sub-Saharan African nations and international agencies signed a consensus that underlies the Equity Initiative in Mali. The Addis Ababa Consensus recognized that cost recovery should be accompanied by protection mechanisms to ensure access to health services. The Joint Equity Initiative was conceived by USAID and UNICEF to develop and test such mechanisms.
The Equity Initiative receives direction from a steering committee led by the Ministry of Health and comprised of key stakeholders. Phase one involves a survey sampling 1600 households in two sites to determine health seeking behavior by target populations. A provider survey follwed, investigating all health services available in both sites from public, private, and traditional sources. Phase two uses the survey results to launch protection mechanisms to improve the utilization of priority health services by target populations. This presentation will occur in Phase two and include experience from the first 6 months using protection mechanisms in pilot sites. Phase three consists of evaluation surveys to measure the impact of the protection mechanisms on utilization.
The household and provider survey data provided rich information on the reasons why people choose to seek care where they do, and the relative importance of price and quality in that choice. After analyzing the data on supply and demand for health services, PHR worked with key stakeholders in pilot sites to put in place protection mechanisms aimed at improving utilization of priority health services by the poorest and most vulnerable segments of the populations.
Learning Objectives: 1. Use survey methods to document supply and demand for health services; 2. Analyze health seeking behavior; 3. Describe mechanisms that can be used to alleviate barriers to care; 4. Evaluate the experience of protection mechanisms in two pilot sites in Mali
Keywords: Access, Measuring Social Inequality
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.