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  • Title: Cameroon and Chad: cost recovery.
    Author: Godin C.
    Journal: Ann Trop Med Parasitol; 1998 Apr; 92 Suppl 1():S163-4. PubMed ID: 9861286.
    Abstract:
    African Ministers of Health adopted the Bamako Initiative in 1987 to ensure sustainable and efficient primary health care (PHC), with an eye toward decreasing levels of morbidity and mortality in Africa. The initiative has made local communities largely responsible for identifying problems and distributing and managing local health care resources. Cost recovery is a key component of the Bamako Initiative. The adoption of a policy of decentralization in which the immediate providers and users of PHC services are responsible for the recovery of costs was recommended. Chad and Cameroon decentralized its health services in 1990 and 1992, respectively. With onchocerciasis one of these 2 countries' most important public health problems, the 2 governments decided to base onchocerciasis control efforts upon the mass distribution of Mectizan (ivermectin, MSD) integrated into the local PHC systems and including cost recovery. Community participation must now be developed to ensure the sustainability of treatment programs in both countries. In both Cameroon and Chad, studies have found that the introduction of cost recovery has had no significant effect upon treatment coverage in hyper- and meso-endemic communities. In fact, those charged for Mectizan treatment often believe that the drug must be worthwhile because they have to pay for it.
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