The Bamako initiative in Benin and Guinea: Improving the effectiveness of primary health care

Daniel Levy-Bruhl, Agnes Soucat, Raimi Osseni, Jean Michel Ndiaye, Boubacar Dieng, Xavier De Bethune, Alpha Telli Diallo, Mamadou Conde, Mohamed Cisse, Yarou Moussa, Kandjoura Drame, Rudolf Knippenberg

Research output: Contribution to journalArticle

Abstract

The objective of the health system revitalization undergone in Benin and Guinea since 1986 is to improve the effectiveness of primary health care at the periphery. Second in a series of five, this article presents the results of an analysis of data from the health centres involved in the Bamako Initiative in Benin and Guinea since 1988. Data for the expanded programme of immunization, antenatal care and curative care, form the core of the analysis which confirms the improved effectiveness of primary health care at the peripheral level over a period of six years. The last available national data show a DPT3 immunization coverage of 80% in 1996 in Benin and 73% in 1995 in Guinea. In the Bamako Initiative health centres included in our analysis, the average immunization coverage, as measured by the adequate coverage indicator, increased from 19% to 58% in Benin and from less than 5% to 63% in Guinea between 1989 to 1993. Average antenatal care coverage has increased from 5% in Benin and 3% in Guinea to 43% in Benin and 51% Guinea. Utilization of coverage with curative care has increased from less than 0.05 visit per capita per year to 0.34 in Guinea and from 0.09 visit pet capita per year to 0.24 in Benin. Further analysis attempts to uncover the reasons which underlie the different levels of effectiveness obtained in individual health centres. Monitoring and microplanning through a problem-solving approach permit a dynamic process of adaptation of strategies leading to a step by step increase of coverage over time. However, the geographical location of centres represents a constraint in that certain districts in both countries face accessibility problems. Outreach activities are shown to play an especially positive role in Guinea, in improving both immunization and antenatal care coverage.

Original languageEnglish (US)
JournalInternational Journal of Health Planning and Management
Volume12
Issue numberSUPPL. 1
DOIs
StatePublished - 1997

Fingerprint

Guinea
Benin
Primary Health Care
health care
coverage
Prenatal Care
Immunization
Health
health
Immunization Programs
Pets
utilization
district
monitoring

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)
  • Health Policy

Cite this

The Bamako initiative in Benin and Guinea : Improving the effectiveness of primary health care. / Levy-Bruhl, Daniel; Soucat, Agnes; Osseni, Raimi; Ndiaye, Jean Michel; Dieng, Boubacar; De Bethune, Xavier; Diallo, Alpha Telli; Conde, Mamadou; Cisse, Mohamed; Moussa, Yarou; Drame, Kandjoura; Knippenberg, Rudolf.

In: International Journal of Health Planning and Management, Vol. 12, No. SUPPL. 1, 1997.

Research output: Contribution to journalArticle

Levy-Bruhl, Daniel ; Soucat, Agnes ; Osseni, Raimi ; Ndiaye, Jean Michel ; Dieng, Boubacar ; De Bethune, Xavier ; Diallo, Alpha Telli ; Conde, Mamadou ; Cisse, Mohamed ; Moussa, Yarou ; Drame, Kandjoura ; Knippenberg, Rudolf. / The Bamako initiative in Benin and Guinea : Improving the effectiveness of primary health care. In: International Journal of Health Planning and Management. 1997 ; Vol. 12, No. SUPPL. 1.
@article{f778d08f496645f497d78f3c43a86ca9,
title = "The Bamako initiative in Benin and Guinea: Improving the effectiveness of primary health care",
abstract = "The objective of the health system revitalization undergone in Benin and Guinea since 1986 is to improve the effectiveness of primary health care at the periphery. Second in a series of five, this article presents the results of an analysis of data from the health centres involved in the Bamako Initiative in Benin and Guinea since 1988. Data for the expanded programme of immunization, antenatal care and curative care, form the core of the analysis which confirms the improved effectiveness of primary health care at the peripheral level over a period of six years. The last available national data show a DPT3 immunization coverage of 80{\%} in 1996 in Benin and 73{\%} in 1995 in Guinea. In the Bamako Initiative health centres included in our analysis, the average immunization coverage, as measured by the adequate coverage indicator, increased from 19{\%} to 58{\%} in Benin and from less than 5{\%} to 63{\%} in Guinea between 1989 to 1993. Average antenatal care coverage has increased from 5{\%} in Benin and 3{\%} in Guinea to 43{\%} in Benin and 51{\%} Guinea. Utilization of coverage with curative care has increased from less than 0.05 visit per capita per year to 0.34 in Guinea and from 0.09 visit pet capita per year to 0.24 in Benin. Further analysis attempts to uncover the reasons which underlie the different levels of effectiveness obtained in individual health centres. Monitoring and microplanning through a problem-solving approach permit a dynamic process of adaptation of strategies leading to a step by step increase of coverage over time. However, the geographical location of centres represents a constraint in that certain districts in both countries face accessibility problems. Outreach activities are shown to play an especially positive role in Guinea, in improving both immunization and antenatal care coverage.",
author = "Daniel Levy-Bruhl and Agnes Soucat and Raimi Osseni and Ndiaye, {Jean Michel} and Boubacar Dieng and {De Bethune}, Xavier and Diallo, {Alpha Telli} and Mamadou Conde and Mohamed Cisse and Yarou Moussa and Kandjoura Drame and Rudolf Knippenberg",
year = "1997",
doi = "10.1002/(SICI)1099-1751(199706)12:1+<S49::AID-HPM466>3.0.CO;2-P",
language = "English (US)",
volume = "12",
journal = "International Journal of Health Planning and Management",
issn = "0749-6753",
publisher = "John Wiley and Sons Ltd",
number = "SUPPL. 1",

}

TY - JOUR

T1 - The Bamako initiative in Benin and Guinea

T2 - Improving the effectiveness of primary health care

AU - Levy-Bruhl, Daniel

AU - Soucat, Agnes

AU - Osseni, Raimi

AU - Ndiaye, Jean Michel

AU - Dieng, Boubacar

AU - De Bethune, Xavier

AU - Diallo, Alpha Telli

AU - Conde, Mamadou

AU - Cisse, Mohamed

AU - Moussa, Yarou

AU - Drame, Kandjoura

AU - Knippenberg, Rudolf

PY - 1997

Y1 - 1997

N2 - The objective of the health system revitalization undergone in Benin and Guinea since 1986 is to improve the effectiveness of primary health care at the periphery. Second in a series of five, this article presents the results of an analysis of data from the health centres involved in the Bamako Initiative in Benin and Guinea since 1988. Data for the expanded programme of immunization, antenatal care and curative care, form the core of the analysis which confirms the improved effectiveness of primary health care at the peripheral level over a period of six years. The last available national data show a DPT3 immunization coverage of 80% in 1996 in Benin and 73% in 1995 in Guinea. In the Bamako Initiative health centres included in our analysis, the average immunization coverage, as measured by the adequate coverage indicator, increased from 19% to 58% in Benin and from less than 5% to 63% in Guinea between 1989 to 1993. Average antenatal care coverage has increased from 5% in Benin and 3% in Guinea to 43% in Benin and 51% Guinea. Utilization of coverage with curative care has increased from less than 0.05 visit per capita per year to 0.34 in Guinea and from 0.09 visit pet capita per year to 0.24 in Benin. Further analysis attempts to uncover the reasons which underlie the different levels of effectiveness obtained in individual health centres. Monitoring and microplanning through a problem-solving approach permit a dynamic process of adaptation of strategies leading to a step by step increase of coverage over time. However, the geographical location of centres represents a constraint in that certain districts in both countries face accessibility problems. Outreach activities are shown to play an especially positive role in Guinea, in improving both immunization and antenatal care coverage.

AB - The objective of the health system revitalization undergone in Benin and Guinea since 1986 is to improve the effectiveness of primary health care at the periphery. Second in a series of five, this article presents the results of an analysis of data from the health centres involved in the Bamako Initiative in Benin and Guinea since 1988. Data for the expanded programme of immunization, antenatal care and curative care, form the core of the analysis which confirms the improved effectiveness of primary health care at the peripheral level over a period of six years. The last available national data show a DPT3 immunization coverage of 80% in 1996 in Benin and 73% in 1995 in Guinea. In the Bamako Initiative health centres included in our analysis, the average immunization coverage, as measured by the adequate coverage indicator, increased from 19% to 58% in Benin and from less than 5% to 63% in Guinea between 1989 to 1993. Average antenatal care coverage has increased from 5% in Benin and 3% in Guinea to 43% in Benin and 51% Guinea. Utilization of coverage with curative care has increased from less than 0.05 visit per capita per year to 0.34 in Guinea and from 0.09 visit pet capita per year to 0.24 in Benin. Further analysis attempts to uncover the reasons which underlie the different levels of effectiveness obtained in individual health centres. Monitoring and microplanning through a problem-solving approach permit a dynamic process of adaptation of strategies leading to a step by step increase of coverage over time. However, the geographical location of centres represents a constraint in that certain districts in both countries face accessibility problems. Outreach activities are shown to play an especially positive role in Guinea, in improving both immunization and antenatal care coverage.

UR - http://www.scopus.com/inward/record.url?scp=8544230641&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=8544230641&partnerID=8YFLogxK

U2 - 10.1002/(SICI)1099-1751(199706)12:1+<S49::AID-HPM466>3.0.CO;2-P

DO - 10.1002/(SICI)1099-1751(199706)12:1+<S49::AID-HPM466>3.0.CO;2-P

M3 - Article

C2 - 10173106

AN - SCOPUS:8544230641

VL - 12

JO - International Journal of Health Planning and Management

JF - International Journal of Health Planning and Management

SN - 0749-6753

IS - SUPPL. 1

ER -