Governing Health Systems in Africa

Seriane.Camara

Description

Drawing on various disciplinary perspectives, this book re-focuses the debate on what makes a good health system, with a view to clarifying the uses of social science research in thinking about health care issues in Africa. The explosion of the HIV/AIDS pandemic, the persistence of malaria as a major killer, and the resurgence of diseases like tuberculosis which were previously under control, have brought about changes in the health system, with implications for its governance, especially in view of the diminished capacity of the public health facilities to cope with a complex range of expanded needs. Government responsibilities and objectives in the health sector have been redefined, with private sector entities (both for profit and not-for profit) playing an increasingly visible role in health care provisions. The reasons for collaborative patterns vary, but chronic under-funding of publicly financed health services is often an important factor. Processes of decentralisation and health sector reforms have had mixed effects on health care system performance; while private health insurance markets and private clinics are pointers to a growing stratification of the health market, in line with the intensified income and social differentiation that has occurred over the last two decades.These developments call for health sector reforms.

Informations

• Publié par: CODESRIA
• Date de parution: 15 mars 2008
• Nombre de lectures: 2
• EAN13: 9782869784031
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Governing Health Systems in AfricaGoverning Health Systems in Africa
Edited by
Martyn Sama and Vinh-Kim Nguyen
Council for the Development of Social Science Research in Africa© Council for the Development of Social Science Research in Africa, 2008
Avenue Cheikh Anta Diop Angle Canal IV, B.P. 3304 Dakar, 18524 Senegal
http://www.codesria.org
All rights reserved.
ISBN: 2-86978-182-2
ISBN 13: 9782869781825
Typeset by Sériane Camara Ajavon
Cover image designed by Ibrahima Fofana
Printed by Graphiplus, Dakar, Senegal
Distributed in Africa by CODESRIA
Distributed elsewhere by the African Books Collective
www.africanbookscollective.com
The Council for the Development of Social Science Research in Africa (CODESRIA) is an
independent organisation whose principal objectives are facilitating research, promoting
researchbased publishing and creating multiple forums geared towards the exchange of views and
information among African researchers. It challenges the fragmentation of research through
the creation of thematic research networks that cut across linguistic and regional boundaries.
CODESRIA publishes a quarterly journal, Africa Development, the longest standing
Africabased social science journal; Afrika Zamani, a journal of history; the African Sociological Review;
African Journal of International Affairs (AJIA); Africa Review of Books; and the Journal of Higher
Education in Africa. It copublishes the Africa Media Review and Identity, Culture and Politics: An
Afro-Asian Dialogue. Research results and other activities of the institution are disseminated
through ‘Working Papers’, ‘Monograph Series’, ‘CODESRIA Book Series’, and the CODESRIA
Bulletin.
CODESRIA would like to express its gratitude to the Swedish International Development
Cooperation Agency (SIDA/SAREC), the International Development Research Centre (IDRC),
Ford Foundation, MacArthur Foundation, Carnegie Corporation, NORAD, the Danish Agency
for International Development (DANIDA), the French Ministry of Cooperation, the United
Nations Development Programme (UNDP), the Netherlands Ministry of Foreign Affairs,
Rockefeller Foundation, FINIDA, CIDA, IIEP/ADEA, OECD, OXFAM America, UNICEF
and the Government of Senegal for supporting its research, training and publication programmes.Contents
Contributors ........................................................................................................ vii
I: Introduction
1 Governing the Health System in Africa ...................................................... 3
Martyn T. Sama and Vinh-Kim Nguyen
II: Governance and Health System Reforms
2 Governance and Primary Health Care Delivery in Nigeria................... 15
Omar Massoud
3 Governing Traditional Health Care Sector in Kenya:
Strategies and Setbacks ................................................................................ 25
Kibet A. Ngetich
4 Corruption et crise des hôpitaux publics à Douala:
Le schémas d’une organisation tripolaire.................................................. 34
Victor Bayemi
5 Health Sector Reforms in Kenya: User Fees ............................................ 44
Alfred Anangwe
6 Decentralisation of Health Care Spending and HIV/AIDS
in Cameroon ................................................................................................. 60
Christopher Sama Molem
7 Another Look at Community-Directed Treatment (ComDT) in
Cameroon: A Quality Challenge to Health System Development ...... 82
Martyn T. Sama and Richard Penn
III: Health Systems and HIV in the Maghreb
8 Le Système de santé au Maghreb .............................................................. 95
Sofiane Bouhdiba
9 La Lutte contre le SIDA en Afrique du Nord ...................................... 116Governing Health Systems in Africavi
IV: Health Systems and Chronic Diseases
10 Les Maladies chroniques non transmissibles dans le système
de santé au Sénégal: Le cas du diabète dans la ville de Dakar ............ 133
Oupa Diossine Loppy
11 La Gestion de maladies chroniques en Algérie: Le Cas du cancer ..... 146
Farida Mecheri
12 Situation des malades tuberculeux perdus de vue en cours de
traitement au centre antituberculeux de Brazzaville (Congo):
Une Revue ................................................................................................... 155
Mbou André
V: Priority Setting and Policy Making
13 Retirement Stress in Nigeria: A Psycho-political Analysis .................... 163
Jane-Frances Agbu
14 Préfinancement communautaire des soins de santé pour
un meilleurs accès des populations rurales aux services de santé
de base: Une estimation du consentement à pre-payer
des ménages au Centre du Cameroun .................................................... 177
Joachim Nyemeck Binam et Valère Nkelzok
15 The Impact of Structural Adjustment Programmes (SAPs)
on Women’s Health in Kenya ................................................................... 191
Damaris S. Parsitau
16 Should We ‘Modernise’ Traditional Medicine?....................................... 201
Mugisha M. Mutabazi
17 Empowering Traditional Birth Attendants in the Gambia: A Local
Strategy to Redress Issues of Access, Equity and Sustainability ............ 225
Stella Nyanzi
VI: Conclusion
18 Social Context and Determinants of HIV Transmission:
Lessons from Africa .................................................................................. 237
Vinh-Kim Nguyen and Martyn T. Sama
References .................................................................................................... 256Contributors
Alfred Anangwe: AIDS Focus, Ministry of Health Nairobi, Kenya.
Christopher Sama Molem: Department of Economic and Management,
Faculty of Social and Management Sciences, University of Buea, Cameroon.
Martyn T. Sama: Tropical Medicine Research Center, Kumba SW Province,
Cameroon.
Vinh-Kim Nguyen: Department of Social and Preventive Medicine, University
of Montréal, Québec, Canada.
Richard Penn: TEYEN Research Foundation, Yaoundé, Cameroon.
Kibet A. Ngetich: Department of Sociology & Anthropology, Egerton
University, Njoro Kenya.
Mugisha M. Mutabazi: Department of Economics, Faculty of Arts & Social
Sciences, Kyambogo University, Uganda.
Stella Nyanzi: MRC Laboratories, Faranni Field Station, Banjul, The Gambia.
Jane-Frances Agbu: Department of Psychology, University of Lagos, Lagos,
Nigeria.
Damaris S. Parsitau: Department of Philosophy & Religious Studies, Egerton
University, Njoro, Kenya.
Omar Massoud: Department of Local Government Studies, Faculty of
Administration, Ahmadu Bello University, Zaria, Nigeria.
Victor Bayemi: Chargé de Cours FSGA Université de Douala, Cameroun.
Christopher Sama Molem: Department of Economic and Management
Faculty of Social and Management Sciences, University of Buea, Cameroon.
Richard Penn: Department of neurology, The University of Chicago Medical
Center.
Sofiane Bouhdiba: Human and Social Sciences Faculty of Tunis, Tunisia.
Oupa Diossine Loppy: Amnesty International 303, Résidence Arame Siga
SacréCoeur II Dakar (Senegal).Governing Health Systems in Africaviii
Farida Mecheri: Département de sociologie, Université Mostaganem, Groupe
de recherche en anthropologie de la santé, Algérie.
Mbou André: Chargé de Cours, Ecole nationale d'administration et de Magistrature,
Brazzaville, Congo.
Damaris Parsitau: Department of Philosophy and Religious Studies, Egerton
University, Kenya.
Joachim Nyemeck Binam: Institut de Recherche Agricole pour le Développement
(IRAD/ASB), Yaoundé, Cameroun.
Valère Nkelzok: Département de Philosophie-Sociologie, Faculté des Lettres
et des Sciences Humaines, Université de Douala.I
Introduction1
Governing the Health System in Africa
Martyn T. Sama & Vinh-Kim Nguyen
Today, health systems in all countries, rich and poor, play a bigger and more
influential role in people’s lives than ever before. Health systems of some sort
have existed for as long as people have tried to protect their health and treat
diseases. Traditional practices, often integrated with spiritual counselling and
providing both preventive and curative care, have existed for thousands of years and
often co-exist today with modern medicine.
Years ago, organised health systems in the modern sense barely existed. Few
people alive then would ever visit a hospital. Most were born into large families
and faced an infancy and childhood threatened by a host of potentially fatal
diseases – measles, smallpox, malaria and poliomyelitis among them. Infant and
child mortality was very high as were maternal mortality rates. Life expectancy
was short.
Health systems have undergone overlapping generations of reforms in the
past years, including the founding of national healthcare systems, and the
extension of social insurance schemes. Later came the promotion of primary health
care as a route to achieving affordable universal coverage - the goal of health for
all. Despite its many virtues, a criticism of this route has been that it gave too little