从西非用户收费的制度化到其废除：试点项目与公共政策的故事。
From institutionalization of user fees to their abolition in West Africa: a story of pilot projects and public policies.
作者信息
Ridde Valéry
出版信息
BMC Health Serv Res. 2015;15 Suppl 3(Suppl 3):S6. doi: 10.1186/1472-6963-15-S3-S6. Epub 2015 Nov 6.
Abstract
This article analyzes the historical background of the institutionalization of user fees and their subsequent abolition in West Africa. Based on a narrative review, we present the context that frames the different articles in this supplement. We first show that a general consensus has emerged internationally against user fees, which were imposed widely in Africa in the 1980s and 1990s; at that time, the institutionalization of user fees was supported by evidence from pilot projects funded by international aid agencies. Since then there have been other pilot projects studying the abolition of user fees in the 2000s, but these have not yet had any real influence on public policies, which are often still chaotic. This perplexing situation might be explained more by ideologies and political will than by insufficient financial capacity of states.
摘要
本文分析了西非实行使用者付费制度及其随后废除该制度的历史背景。基于叙述性综述，我们呈现了构成本增刊中不同文章框架的背景情况。我们首先表明，国际上已出现反对使用者付费的普遍共识，这种付费方式在20世纪80年代和90年代在非洲广泛推行；当时，使用者付费制度得到了国际援助机构资助的试点项目证据的支持。自那时起，在21世纪又有其他研究废除使用者付费制度的试点项目，但这些项目尚未对往往仍混乱无序的公共政策产生任何实际影响。这种令人困惑的情况或许更多是由意识形态和政治意愿而非国家财政能力不足造成的。
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