Bamako declaration on an african common position on the illicit proliferation, circulation and trafficking of small arms and light weapons 1 december 2000 i. Bamako initiative of 1987 bamako initiative ensure. User fees refer to a financing mechanism that has two main characteristics. The bamako initiative bi the bamako initiative bi was a pragmatic strategy to implement primary health care phc in the era of economic structural adjustment. We also learned that this power is not free to have and it needs to be. President, the bamako initiative is a testament to the hard work and solidarity of untold numbers of dedicated people on the ground many of you here, at this important conference who understood from the very beginning that the key to accessible and affordable health care for all lies in the informed involvement of local communities. User fees can entail any combination of drug costs, supply and medical material costs, entrance fees or consultation fees. Bamako declaration of the african statesmen initiative june 8. To compare the level of availability and rational use of drugs in primary health care phc facilities where the bamako initiative bi drug revolving fund programme has been operational, with phc centres where the bitype of drug revolving fund programme is not yet operational. The strategies implemented in these two countries are discussed. Full text full text is available as a scanned copy of the original print version. A platform for a pollution free africa second meeting of the conference of the parties to the bamako convention ministerial segment meeting abidjan, 30 january 1 february 2018 note from the secretariat twenty years of the bamako convention. Book your tickets online for the top things to do in bamako, mali on tripadvisor. Improving access to essential drugs for rural communities in.
The bamako initiative bi was introduced by whounicef in the late 1980s to improve access to essential drugs for the most vulnerable in the society and thus improve the health outcomes. A time for more effective implementation executive summary. The bamako initiative was a formal statement adopted by african health ministers in 1987 in. The novartis foundation in mali is represented by a head of delegation, who is joined in the bamako office by a financial manager. This point is illustrated by the bamako initiative planning guide 28 which notes three levels of community health workers, community mobilization, and community. This evaluation focuses particularly on the community financing aspects of the initiative. Mali announces farreaching health reform the lancet. Sp otlight on the bamako initiative 77 ed with the quality of care, although 48 percent were not fully satis ed. Locally manufactured goods include textiles, processed meat, and metal goods. The impact of user fees on health service utilization in low. The 10 best things to do in bamako for travel after. Facility users preference between the free and the bamako. Anita hardon, ten best readings in the bamako initiative, health policy and planning, volume 5, issue 2, june 1990. Immunization and oral rehydration therapy were supplied free of charge.
More than 30 years ago, the bamako initiative launched in mali during the world health organization regional assembly. The inability of the phc and bamako initiative and other international initiatives to improve access and quality of healthcare in subsaharan africa and other development regions in the late 1980s and early 1990s led to search for alternatives to health policy making. The bamako initiative bi launched in 1987, was prompted by unicef and who as community management of revolving drug funds. The bamako initiative was a formal statement adopted by african health ministers in 1987 in bamako, mali, to implement strategies designed to increase the availability of essential drugs and other healthcare services for subsaharan africans. Ensure community participation in managing and finding supplies of essential drugs improving primary healthcare services for all decentralising the management of primary health services to district level decentralising the management of locally collected patient fees to community level ensuring consistent fees are charged at all levels for health services whether in. You can help by expanding it with reliably sourced entries. Bamako s river port is located in nearby koulikoro, along with a major regional trade and conference center. Apr 16, 20 he was the manager of the bamako initiative support unit at the unicef hq. During the 1987 world health organizations regional assembly, the ministers of health of the african states launched the bamako initiative, an effort aimed at reorganizing the health system to ensure universal, permanent accessibility of maternal and child health services. Signed by health ministers from across the continent, the bamako initiative popularized user fees, asking patients to pay for their own health care costs out of pocket. They are typically paid for each visit to a health service provider, although in some cases followup visits for the same.
Bamako declaration of the african statesmen initiative june 8, 2005 we, 15 former heads of state and government from across the african continent, have gathered in bamako, mali, from june 5 to 8, 2005, to discuss the individual and collaborative contributions that former leaders can make to address the urgent challenges facing africa today. Faced with the difficulty of implementing primary health care services as proposed at almaata, unicef and the world health organization launched a new public health policy in 1987, the bamako initiative, to improve access to health care by revitalizing primary health care. Ten best readings in the bamako initiative health policy. Nov 12, 2019 in 1987, african health ministers met in the malian capital to adopt a new approach to healthcare, which became known as the bamako initiative. Bamako initiative 1987 decentralize health care to the district level, essential drugs supported by the world bank through 1980s this is the basic system to pay for health care services and dominates developing countries. Pdf on oct 1, 1989, d hughes and others published the bamako initiative find, read and cite all the research you need on researchgate. These strategies were launched as the bamako initiative by the world health organizations regional assembly in 1987. The bamako initiative, a controversial attempt to strengthen primary health care using community financing and community participation and management was launched at a meeting of african ministers of health in 1987. Bamako initiative employed some form of phased scaling up, and several countries most notably benin, mali and rwanda achieved significant results. Under the bamako initiative unicef will provide free drugs to participating countries for the 1st few years. The premise of the bamako initiative was that the cost of providing primary health care the equivalent of ones family doctor would be collected by charging patients for drugs at a price higher than cost, a technique called revolving drug funds the extra money raised from medicine charges is used to pay for other facets of healthcare.
Facility users preference between the free and the bamako initiative drug revolving fundbased health services in iwajowa local government, oyo state background. Bamako is the seventhlargest west african urban center after lagos, abidjan, kano, ibadan, dakar, and accra. The few patients that still visited knew that they would have to pay for the free services and that there would be no drugs in the health unit. These strategies were launched as the bamako initiative by the world health. Free on request from unicef house, 3 united nations plaza. However, bi institutionalized user fees for essential medicines in some of the poorest countries in the world. Ten best readings in the bamako initiative, health policy and planning, volume 5, issue 2, 1 june 1990, pages 186189. Following the bamako initiative, rwanda decentralized management and districtlevel care strategy with the development of provinciallevel health offices for health system management. In essence, implementing the bamako initiative was a political process that involved changing the prevailing patterns of authority and power. This is a dynamic list and may never be able to satisfy particular standards for completeness. An alternative is the concept of the user fee, cost sharing, costrecovery or copayment. Bamako declaration on an african common position on the. Former head of the bamako initiative management unit, unicef, new york.
Get a printable copy pdf file of the complete article 505k, or click on a page image below to browse page by page. The bamako initiative, sponsored by unicef and who and adopted by african. In the first part of the interview we publish today, he shares his analysis of the setup of the bamako initiative. The bamako initiative was launched in 1987 in the capital. The drug revolving fund drf was instituted in 1996 in oyo state to ensure sustainable drug availability at primary health care level with a seed stock of drugs supplied by the. Links to pubmed are also available for selected references. Formal statement adopted by african health ministers in 1987 in bamako, mali, to implement strategies designed to increase the availability of essential drugs. The bamako initiative program bi sought to accelerate and strengthen the implementation of primary health care phc, with the goal of achieving universal accessibility to these services. We, the ministers of the members states of the organization of african unity met in bamako, mali, from 30 november to 1 december 2000, to develop an. It was an initiative that african ministers of health introduced in 1987 to reorganize and strengthen primary. The following is a timeline of the history of the city of bamako, mali. The initiative acces is managed by a regional coordinator, along with a specialist in.
The bamako initiative community health nursing bscn iii. In 19921993, burkina faso implemented the bamako initiative, a health sector reform in subsaharan africa that included several strategies, one of which was the implementation of user charges to. It is based around the eight principles listed at the top of this page see box. The community are expected to retain the evaluation of the bamako initiative funds generated from profits on sales of drugs, and use these funds within the community health system. The novartis foundation for sustainable development in mali. Full text get a printable copy pdf file of the complete article 304k, or click on a page image below to browse page by page. Health care users found the availability of drugs to be high over 80 percent said drugs were av ailable and the overall quality of care to be good 91 percent. The bamako initiative was not about money agostino paganini, president, unicef global staff association former head of the bamako initiative management unit, unicef, new york abstract the bamako initiative bi was a pragmatic strategy to implement primary health care phc in the era of economic structural adjustment. The bamako initiative was agreed by african ministers of health in 1987 with who and unicef, calling for community participation in managing and funding supplies of essential drugs. This is the first in a series of five articles on the bamako initiative in benin and guinea.
Did the bamako initiative improve the utilization of maternal. Effect of the bamakoinitiative drug revolving fund on. The unit worked closely with african countries that had shown interest in the principles of the bamako initiative. Providing essential drugs the bamako initiative tearfund. He was the manager of the bamako initiative support unit at the unicef hq. The bamako initiative, implemented in varying degrees in half of the countries of subsaharan africa since the late 1980s, has shown that organized communities can help sustain local public health services, not only by contributing resources but also by. One of the major indices of the performance of the primary healthcare delivery remains improved access to essential drugs. Is the bamako initiative still relevant for west african. Mar 23, 2019 the reforms announced by the malian government are in sharp contrast with the bamako initiative that was sponsored by unicef and who and was adopted by african ministers of health in 1987, in bamako, the capital of mali. Can a low income country move towards universal health.691 153 396 1570 588 470 864 1310 241 121 1276 977 1252 526 41 1430 1217 352 149 582 1437 1432 1587 501 818 1226 1415 932 150 421 392 270 548 40 470 35 1137 1412 879 223 1125 1191