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Rapid Assessment of the Health System in Benin, April 2006

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Rapid Assessment of the Health System in Benin, April 2006 Rapid Assessment of the Health System in Benin, April 2006 Grace Adeya Alphonse Bigirimana Karen Cavanaugh Lynne Miller Franco Printed: February 2007 Rapid Assessment of the Health System in Benin, April 2006 This report was made possible through support provided by the U.S. Agency for International Development. The opinions expressed herein are those of the author(s) and do not necessarily reflect the views of the U.S. Agency for International Development. About RPM Plus RPM Plus works in more than 20 developing and transitional countries to provide technical assistance to strengthen pharmaceutical and health commodity management systems. The program offers technical guidance and assists in strategy development and program implementation both in improving the availability of health commodities—pharmaceuticals, vaccines, supplies, and basic medical equipment— of assured quality for maternal and child health, HIV/AIDS, infectious diseases, and family planning and in promoting the appropriate use of health commodities in the public and private sectors. About MEASURE Evaluation MEASURE Evaluation is a project funded by the U.S. Agency for International Development (USAID) and implemented by the Carolina Population Center at the University of North Carolina at Chapel Hill in partnership with Tulane University, ORC Macro International, John Snow, Inc., and Constella Futures. As a key component of USAID’s Monitoring and Evaluation to Assess and Use Results (MEASURE) framework, the project promotes a continuous cycle of data demand, collection, analysis and utilization to improve population and health conditions. Since 1997, MEASURE Evaluation has worked around the world to strengthen the capacity of host-country programs to collect and use population and health data. About Quality Assurance Project The Quality Assurance Project (QAP) seeks to strengthen the quality of health care in developing and middle income countries, in support of USAID’s Bureau for Global Health and country Missions. QAP seeks to promote the application of effective improvement methodologies to strengthen quality of priority health services; institutionalize quality assurance activities at a national or regional level; document and evaluate improvements in human resource management that affect quality of care; and improve outcomes in the priority health areas, such as child survival, family planning, HIV/AIDS, malaria, safe motherhood, and tuberculosis. The Quality Assurance Project provides long-term and short term technical assistance, training, research and computer based learning. The Quality Assurance Project is active in 15 countries, three regional initiatives, and two global initiatives. Recommended Citation This report may be reproduced if credit is given. Please use the following citation. Adeya, G., A. Bigirimana, K. Cavanaugh, and L. Miller Franco. 2007. Rapid Assessment of the Health System in Benin, April 2006. Submitted to the U.S. Agency for International Development. Key Words Benin, Health Systems, Governance, Stewardship, Health Financing, Health Service Delivery, Human Resource Management, Pharmaceutical Management, Health Information System, Private Sector ii CONTENTS ACRONYMS................................................................................................................................ vii ACKNOWLEDGMENTS ............................................................................................................. ix SECTION 1: INTRODUCTION .................................................................................................... 1 Methodology: The Health Systems Assessment Approach........................................................ 2 Preassessment Activities............................................................................................................. 3 In-Country Assessment............................................................................................................... 3 Challenges................................................................................................................................... 3 SECTION 2: BACKGROUND ...................................................................................................... 5 Overview..................................................................................................................................... 5 Political and Macroeconomic Environment................................................................................ 6 Major Causes of Morbidity and Mortality.................................................................................. 7 SECTION 3: OVERVIEW OF THE HEALTH SYSTEM IN BENIN .......................................... 9 Structure of Health Care System.................................................................................................9 Decentralization and Organization of Service Delivery ............................................................. 9 SECTION 4: SUMMARY OF THE ASSESSMENT FINDINGS............................................... 15 Stewardship............................................................................................................................... 15 Health Financing....................................................................................................................... 23 Health Service Delivery............................................................................................................ 33 Human Resources ..................................................................................................................... 38 Pharmaceutical Management.................................................................................................... 38 Health Information Systems ..................................................................................................... 38 Private Sector Engagement....................................................................................................... 38 Summary of Strengths and Weaknesses of Benin’s Health System......................................... 38 SECTION 5: PRIORITY INTERVENTIONS FOR CONSIDERATION AND ACTION ......... 38 Possible Options for Strengthening Health System Governance.............................................. 38 Possible Options for Improving Incentives for Health System Performance and Management of Human Resources for Health................................................................................................ 38 Possible Options for Improving Health Financing ................................................................... 38 SECTION 6: OPTIONS FOR USAID.......................................................................................... 38 Improving Financial Protection in Health................................................................................. 38 Improving Information.............................................................................................................. 38 Fostering Greater Public-Private Integration............................................................................ 38 ANNEX 1. SUMMARY OF PROPOSED INTERVENTIONS BY ASSESSMENT MODULE 38 Stewardship............................................................................................................................... 38 Health Financing....................................................................................................................... 38 Health Service Delivery............................................................................................................ 38 Human Resources Management ............................................................................................... 38 iii Rapid Assessment of the Health System in Benin, April 2006 Pharmaceutical Management.................................................................................................... 38 Health Information Systems ..................................................................................................... 38 Private Sector Engagement....................................................................................................... 38 ANNEX 2. IN-COUNTRY ASSESSMENT SCHEDULE .......................................................... 38 ANNEX 3. CONTACTS .............................................................................................................. 38 Central Level............................................................................................................................. 38 Department of Mono/Couffo .................................................................................................... 38 Department of Zou/Collines ..................................................................................................... 38 ANNEX 4. SOURCES.................................................................................................................. 38 Background............................................................................................................................... 38 Overview of Health System...................................................................................................... 38 Stewardship............................................................................................................................... 38 Health Financing....................................................................................................................... 38 Health Service Delivery...........................................................................................................
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