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Table 4 Synthesis of the results of the transversal analysis for the six countries’ knowledge aggregation process

From: Transversal analysis of public policies on user fees exemptions in six West African countries

Implementation Component

Management (S1)

Majority of State financing

Maintenance of centrally organized financing

Multiplicity of reimbursement methods

Reimbursement delays and/or stock shortages

Almost no implementation guides

Lack of support measures

Communication (S2)

Communication plans that were rarely carried out, funded or renewed

Health workers who were given general information but not details

Poorly informed populations

Monitoring / Evaluation / Coordination (S3)

Almost no monitoring and evaluation systems

Ineffective and poorly funded coordination systems

Community involvement (S4)

Low levels of community involvement

Patient management and referral (S5)

Incomplete exemption policies

Partial referral-evacuation systems

Actors’ Attitudes

Health workers’ motivation and satisfaction (A1)

Objectives that were appreciated

Dissatisfaction with the implementation

Provider–patient relationship (A2)

Specific tensions

Patients’ satisfaction (A3)

Overall satisfaction

But still some problems

Patients’perceptions on health and on financial access to care (A4)

The financial barrier has been removed but other barriers persist

Health workers’ coping strategies (A5)

Reorganization of practices

Service rationing due to lack of reimbursement

Overcharging or shifting of resources

  1. Sources: country case studies.