Goal 4: decentralisation and sustainability
Assessment of Niger’s national cost recovery policy implementation in the primary health care sector
Health user fees aided reform efforts in Niger – but failed to protect the poor
Authors:
F.D. Diop
Publisher:
Partners for Health Reformplus , 1996
This report, produced by Partners for Health Reform Plus, presents the strengths and weaknesses of Niger’s cost recovery policy for primary health care services and makes recommendations for the short- and long-term for the country’s Ministry of Health. Strengths as to how the policy was implemented included the development of a new financial management system to safeguard revenues and ensure their judicious use by health committees.Drug management procedures were also improved and simplified, and district medical personnel were trained in the use of standardised diagnosis and treatment protocols, and essential drugs. Combined with the ability to generate more income through user fees, these changes led to improvements in the availability of generic drugs.
However, the paper argues that income generated by cost recovery mechanisms cannot replace government funding, and that means testing policies are needed to protect the poor. In addition to addressing these issues, it recommends a major effort by the Ministry of Health to raise awareness of the new policy. It concludes that all central bureaus and agencies of the Ministry need to become more involved in cost recovery activities and to help reinforce the goals and objectives of the country’s national programme for strengthening primary health care.
