Ridde Valéry, Meessen Bruno, Kouanda Seni
CRCHUM, Département de médecine sociale et préventive, Université de Montréal - 3875, rue Saint-Urbain, Unité de santé internationale, H3V1H4 Montréal, Canada.
Sante Publique. 2011 Jan-Feb;23(1):61-7.
As the idealistic deadline of the Millennium Development Goals (MDGs), 2015, looms ever closer, some are calling for user fees abolition. In many African countries, this involves targeting groups considered vulnerable. However, operational problems have surfaced in the experiences of some of the pioneering West African countries. We identified various health system bottlenecks. These challenges are also starting points and opportunities to strengthen health care systems in Africa through making changes such as significantly increasing health care funding, improving the reliability of funding, making equity a health policy priority, adopting "New Public Management" types of reforms, ensuring the supply and quality of inputs, making efforts to reinforce the systemic components of the health sector, and improving the quality and quantity of evaluations undertaken in the health sector.
随着千年发展目标（MDGs）设定的理想截止日期2015年日益临近，一些人呼吁取消用户收费。在许多非洲国家，这涉及针对那些被视为弱势群体的群体。然而，一些西非先驱国家的经验中出现了操作问题。我们识别出了各种卫生系统瓶颈。这些挑战也是通过做出如下改变来加强非洲医疗保健系统的起点和机遇：大幅增加医疗保健资金、提高资金的可靠性、将公平作为卫生政策的优先事项、采用“新公共管理”类型的改革、确保投入的供应和质量、努力加强卫生部门的系统组成部分，以及提高卫生部门进行的评估的质量和数量。
