Findings in the Area of Health Insurance Reported from Department of Public Health (‘Rowing against the current’: the policy process and effects of…

Findings in the Area of Health Insurance Reported from Department of Public Health ('Rowing against the current': the policy process and effects of removing user fees for caesarean sections in Benin)

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- Data detailed on Health Insurance have been presented. According to news reporting originating in Cotonou, Benin, by NewsRx journalists, research stated, "In 2009, the Benin government introduced a user fee exemption policy for caesarean sections. We analyse this policy with regard to how the existing ideas and institutions related to user fees influenced key steps of the policy cycle and draw lessons that could inform the policy dialogue for universal health coverage in the West African region."

Funders for this research include Directorate-general Development Cooperation and Humanitarian Aid, Seventh Framework Programme (see also Health Insurance).

The news reporters obtained a quote from the research from the Department of Public Health, "Following the policy stages model, we analyse the agenda setting, policy formulation and legitimation phase, and assess the implementation fidelity and policy results. We adopted an embedded case study design, using quantitative and qualitative data collected with 13 tools at the national level and in seven hospitals implementing the policy. We found that the initial political goal of the policy was not to reduce maternal mortality but to eliminate the detention in hospitals of mothers and newborns who cannot pay the user fees by exempting a comprehensive package of maternal health services. We found that the policy development process suffered from inadequate uptake of evidence and that the policy content and process were not completely in harmony with political and public health goals. The initial policy intention clashed with the neoliberal orientation of the political system, the fee recovery principles institutionalised since the Bamako Initiative and the prevailing ideas in favour of user fees. The policymakers did not take these entrenched factors into account. The resulting tension contributed to a benefit package covering only caesarean sections and to the variable implementation and effectiveness of the policy."

According to the news reporters, the research concluded: "The influence of organisational culture in the decision-making processes in the health sector is often ignored but must be considered in the design and implementation of any policy aimed at achieving universal health coverage in West African countries."

For more information on this research see: 'Rowing against the current': the policy process and effects of removing user fees for caesarean sections in Benin. Bmj Global Health, 2018;3(1):e000537.

Our news correspondents report that additional information may be obtained by contacting J.P. Dossou, Dept. of Public Health, Research Centre in Human Reproduction and Demography, Cotonou, Benin. Additional authors for this research include J.A. Cresswell, P. Makoutode, V. De Brouwere, S. Witter, V. Filippi, L.G. Kanhonou, S.B. Goufodji, I.L. Lange, L. Lawin, F. Affo and B. Marchal.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1136/bmjgh-2017-000537. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Keywords for this news article include: Benin, Africa, Cotonou, Hospitals, Health Insurance, Health and Medicine.

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