Bamako Initiative
Bamako Initiative
The Bamako Initiative passed in August 1987, which implemented primary health care arose in response to increasing poverty and the lacking health care in Africa. This was primarily due to falling commodity prices and the difficulties of loan repayment. After Nigeria became independent, the government realized the large amount of money needed to provide access to health care for the people. They realized that providing free healthcare would quickly ruin the country’s economy. The large out of pocket payments led to financial burden to the citizens and an overall reduction of healthcare utilization (Leive & Xu, 2008). They realized the financial burden would put the country in financial ruin. This initiative was adopted at a time of economic and political crisis in Africa.
Due to the lack of health resources, many health workers were prescribing drugs to be bought from private outlets, most of which were unlicensed and unsupervised. Creating a lack of confidence in the health care system by many patients. The Bamako initiative focused on increasing access to healthcare. It also greatly focused on slowing government spending on social programs. Another goal of the Initiative was to create ways of new funding, such as private and informal sectors to aid the public system (UNICEF, 2000). The basis for Bamako Initiative was the cost of providing primary health care, would be funded by raising the cost of drugs to patients. This method is known as revolving drug funds, the extra revenue created by selling drugs at a higher cost would then be used to cover other parts of public health care. (Rosner, Leppert, Degens & Ouedraogo, 2012). Creating a more sustainable healthcare system.
The Bamako Initiative was created by UNICEF, part of the United Nations. Prior to this the World Bank and International Money Fund were trying to create structural adjustment programs (SAPs) in under developed countries, in order to stimulate economies economic growth and solve poverty issues in these countries (Omololu, Okunola, & Salami, 2012). These SAPs were hard on the people of these countries, and had an ideology that the only way to overcome this was to work harder, and make them contribute more money to the social programs, and in turn letting the government cut contributions. The initiative was one solution from the United Nations to SAPs, with a goal of enhancing economic growth, as well as finding a continual approach financing social health care programs on the community level.
Implementation of the Bamako initiative was a political process involving changes of authority and power. Shifting the power from a community aspect, to the health facility level, ensuring the accountability of public health services. Creating this level of oversight allowed better management of resources and ensured accountability of public health services to users. Health committees held