International Journal of Health Economics and Policy

| Peer-Reviewed |

Sectoral Effects of Public Policy Reforms in Benin: Case of the Health System

Received: 10 August 2020    Accepted: 31 August 2020    Published: 10 September 2020
Views:       Downloads:

Share This Article

Abstract

The closure of illegal health facilities and the elimination of dual membership of health professionals have been part of health reforms since 2016 in Benin. This research was intended to deeply analyze the immediate effects of new reforms in hospitals and assess governance implications. Methods: The research was a retrospective analysis conducted by a mixed method, using both qualitative and quantitative primary data from three public hospitals and one confessional, from the national public health office and of administration and finances office. Health human resources and their complaints, attendance at health care units, monthly hospital revenues and corrupt practices were used as variables. The research covered the first semesters of 2018 and 2019. The sample was made by reasoned choice. Results: Attendance increased at public hospitals from 12% to 80% and their monthly revenues up to 200% in 2019 and hospitals staffs were present with overload of work. The private hospital suffered a drop of-33% in attendance and-5% in monthly revenues, followed by a staff shortage. Discussion: The reforms have given confidence to public health facilities users and revealed the weak hospitals capacity and difficulties in managing patient flows and staff. Conclusion: There’s a start in improving practices for better hospital performance. Government involvement and technical platforms strengthening are crucial for sustainable results and private hospitals must recruit their own staff.

DOI 10.11648/j.hep.20200503.12
Published in International Journal of Health Economics and Policy (Volume 5, Issue 3, September 2020)
Page(s) 54-62
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Governance, Performance, Hospital, Reforms, Health System

References
[1] L. Salami, E.-M. Ouendo, and B. Fayomi, "Quality of the Health Intervention Information and Monitoring System in Results-Based Funding Areas in 2014 in Benin," Pan Afr Med J, Vol. 28, Nov. 2017, doi: 10.11604/pamj.2017.28.257.10967.
[2] D. Grodos and R. Tonglet, "Mastering a coherent and efficient health space in sub-Saharan African cities: the health district to be tested," Tropical Medicine - International Health, 7, No. 11, p. 977-992, 2002, doi: 10.1046/j.1365-3156.2002.00925.xi.
[3] J.-D. Rainhorn and M.-J. Burnier, Ed., Health at Market Risk: Uncertainties at the Dawn of the 21st Century. Geneva: Graduate Institute Publications, 2017.
[4] P. Fournier, S. Haddad, and P. Mantoura, "Health System Reforms in Developing Countries: The Irresistible Grip of International Agencies and the Dangers of Single Thinking," in Health at Market Risk: Uncertainties at the Dawn of the 21st Century, J.-D. Rainhorn and M.-J. Burnier, Geneva: Graduate Institute Publications, 2017, 71-84.
[5] MoH, "Health Statistics Yearbook 2016," 165, 2016.
[6] MoH, "Health Statistics Directory." 2017.
[7] INSAE, MPD, "Demo Figureic and Health Survey in Benin," INSAE, Benin, Fifth, 2019.
[8] Y. G. Ahanhanzo, L. S. L. Ouédraogo, and J. Saizonou, "Performance of a Health Zone Hospital in Benin: An Example of Evaluation Model," Pan Afr Med J, 18, May 2014, doi: 10.11604/pamj.2014.18.63.3465.
[9] CTRSS, "Summary Report of the Technical Commission in charge of Reforms in the Health Sector.pdf," Benin, 2017.
[10] Zongo M., Capochichi J., Gandaho P., Takpara I., and Coppieters Y., "Managerial Management of Hospital Structures in Benin," 2009.
[11] Chirac Foundation, "The Cotonou Appeal, October 12, 2009." 2009, Consulted on: August 15, 2019. [Online]. Available on: https://www.fondationchirac.eu/prevention-conflits/acces-aux-medicaments/mobilisation-internationale-contre-trafic-faux-medicaments/.
[12] CTRSS, “RAPPORT GENERAL CTRSS BÉNIN 2017.PDF”. 2017.
[13] WHO, Ed., Funding health systems: the path to universal coverage. Geneva, 2010.
[14] D. B. Reissman, P. Orris, R. Lacey, and D. E. Hartman, “Downsizing, role demands, and job stress”, J. Occup. Environ. Med., vol. 41, no 4, p. 289-293, avr. 1999, doi: 10.1097/00043764-199904000-00011.
[15] Mordelet Patrick, Hospital Governance and the Health Systems Crisis. School of Higher Studies in Public Health, 2006.
[16] M. Razafindrakoto and F. Roubaud, "Governance Indicators: Relevance, Use and Limits," 31, 2007.
[17] S. Siddiqi and coll., “Framework for assessing governance of the health system in developing countries: Gateway to good governance”, Health Policy, vol. 90, no 1, p. 13-25, apr. 2009, doi: 10.1016/j.healthpol.2008.08.005.
[18] G. Charreaux, "Hospital Governance: Some Reflections From Corporate Governance," FARGO Paper 1100705.
[19] J.-P. O. de Sardan, "The midwife and the customs officer. Local occupational cultures and privatized bureaucratic culture in West Africa," Other, 20, No. 4, 61, 2001, doi: 10.3917/autr.020.0061.
[20] Sarrah Bennett, Kara Hanson, Patrick Kadama, and Dominic Montagu, "WORK WITH THE PRIVE SECTOR FOR REALISER THE PUBLIC HEALTH OBJECTIVES," Geneva, 2005.
[21] M. Lewis, “Governance and Corruption in Public Health Care Systems”, SSRN Journal, 2006, doi: 10.2139/ssrn.984046.
[22] P. Bardhan, «Corruption and Development: A Review of Issues», Journal of Economic Literature, vol. 35, no 3, p. 1320-1346, 1997.
[23] A. Shleifer et R. W. Vishny, “Corruption”, The Quarterly Journal of Economics, vol. 108, no 3, p. 599-617, 1993, doi: 10.2307/2118402.
[24] G. Charreaux, "For "behavioural" corporate governance. An exploratory reflection... French Management Journal, 31, 157, 215-238, Jul. 2005, doi: 10.3166/rfg.157.215-238.
[25] B. Coriat and O. Weinstein, "The firm's theories between "contracts" and "skills." A Critical Review of Contemporary Developments, Industrial Economics Review, 129-130, 57-86, June 2010, doi: 10.4000/rei.4142.
[26] Presidency of the Republic of Benin, "The Government's Programme of Actions." March 2017, Consulted: August 22, 2020. [Online]. Available on: http://revealingbenin.com/wp-content/uploads/2017/03/Le-Programme-dActions.pdf.
[27] Edgard-Marius D. OUENDO and al., "Universal Coverage in French-speaking Africa: Towards the Learning Organization." March 27, 2017, Consulted: August 22, 2020. [online]. Available on: http://www.healthfinancingafrica.org/uploads/8/0/8/8/8088846/votre_syste%CC%80me_csu_est_il_apprenant_rapport_benin.pdf.
[28] «Rapid Assessment of the Health System in Benin, April 2006», SAGE Publications, Inc., 2455 Teller Road, Thousand Oaks California 91320 United States, 2011. doi: 10.4135/9781412994064.n303.
[29] Abt Associates Inc, “SHOPS Project. 2013. Benin Private Health Sector Assessment. Brief. Bethesda, MD: Strengthening Health Outcomes through the Private Sector Project, Abt Associates Inc”, Benin, sept. 2013. Consulté le: août 22, 2020. [online]. Available on: https://www.abtassociates.com/sites/default/files/migrated_files/5009aaae-6662-434a-aad1-7a5934f0eb9b.pdf.
[30] S. J. Adanmavokin, S. G. Armand, I. B. Charlemagne, et O. Edgard-Marius, «Application of the WHO Method of Workload Indicators of Staffing Needs to Evaluate Health Workers Availability and Capacity for Universal Health Coverage in Maternal and Child Health in Benin», Universal Journal of Public Health, vol. 8, n° 5, p. 163-178, sept. 2020, doi: 10.13189/ujph.2020.080502.
[31] B. HOUNKPATIN, "Breaking Year 4: Health Sector - Benjamin HOUNKPATIN Unveils the New Face of the Health Sector," Apr. 24, 2019.
[32] T. Benmarhnia and D. Fuller, "Quasi-Experimental Methods," in Evaluation of Global Health Interventions, Science and Common Good Editions and IRD Editions, 2019.
[33] INSAE, MPD, "Population," Statistics for the Nation, 2020. https://www.insae-bj.org/statistiques/indicateurs-recents/43-population (consulted August 24, 2020).
[34] Treasury Board of Canada Secretariat, "Data Assessment and Development Strategic Policy Human Resources Development Canada." Feb 25, 2010, Consulted: August 21, 2020. [Online]. Available on: https://www.tbs-sct.gc.ca/cee/pubs/meth/pem-mep-fra.pdf.
[35] MoH, "Sanitary Statistics 2019" Yearbook. Ministry of Health, March 2020, [Online]. Available on: www.sante.gouv.bj.
[36] Presidency of the Republic of Benin, "Law 97-020 of June 17, 1997," General Secretariat of the Government of Benin, June 17, 1997. https://sgg.gouv.bj/doc/loi-97-020/ (consulted August 26, 2020).
[37] Presidency of the Republic of Benin, "Decree No. 2018-342 of July 25, 2018," General Secretariat of the Government of Benin, J. D. 25, 2018. https://sgg.gouv.bj/doc/decret-2018-342/ (consulted August 22, 2020).
[38] G. Vincent, "Hospital Reforms," French Public Administration Review, No. 113, No. 1, 49-63, 2005.
[39] M. Hensher and N. Edwards, “The hospital of the future: Hospital provision, activity, and productivity in England since the 1980s”, BMJ, vol. 319, n° 7214, p. 911-914, oct. 1999, doi: 10.1136/bmj.319.7214.911.
Author Information
  • Thies Applied Economics and Finance Research Centre, Department of Economics and Social Science, University of Thies, Thies, Senegal

  • Thies Applied Economics and Finance Research Centre, Department of Economics and Social Science, University of Thies, Thies, Senegal

  • Faculty of Social Sciences, University of Liège, Liège, Belgium

Cite This Article
  • APA Style

    Prince Comlan Eugene Adjovi, Ibrahima Thiam, Fabienne Fecher. (2020). Sectoral Effects of Public Policy Reforms in Benin: Case of the Health System. International Journal of Health Economics and Policy, 5(3), 54-62. https://doi.org/10.11648/j.hep.20200503.12

    Copy | Download

    ACS Style

    Prince Comlan Eugene Adjovi; Ibrahima Thiam; Fabienne Fecher. Sectoral Effects of Public Policy Reforms in Benin: Case of the Health System. Int. J. Health Econ. Policy 2020, 5(3), 54-62. doi: 10.11648/j.hep.20200503.12

    Copy | Download

    AMA Style

    Prince Comlan Eugene Adjovi, Ibrahima Thiam, Fabienne Fecher. Sectoral Effects of Public Policy Reforms in Benin: Case of the Health System. Int J Health Econ Policy. 2020;5(3):54-62. doi: 10.11648/j.hep.20200503.12

    Copy | Download

  • @article{10.11648/j.hep.20200503.12,
      author = {Prince Comlan Eugene Adjovi and Ibrahima Thiam and Fabienne Fecher},
      title = {Sectoral Effects of Public Policy Reforms in Benin: Case of the Health System},
      journal = {International Journal of Health Economics and Policy},
      volume = {5},
      number = {3},
      pages = {54-62},
      doi = {10.11648/j.hep.20200503.12},
      url = {https://doi.org/10.11648/j.hep.20200503.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.hep.20200503.12},
      abstract = {The closure of illegal health facilities and the elimination of dual membership of health professionals have been part of health reforms since 2016 in Benin. This research was intended to deeply analyze the immediate effects of new reforms in hospitals and assess governance implications. Methods: The research was a retrospective analysis conducted by a mixed method, using both qualitative and quantitative primary data from three public hospitals and one confessional, from the national public health office and of administration and finances office. Health human resources and their complaints, attendance at health care units, monthly hospital revenues and corrupt practices were used as variables. The research covered the first semesters of 2018 and 2019. The sample was made by reasoned choice. Results: Attendance increased at public hospitals from 12% to 80% and their monthly revenues up to 200% in 2019 and hospitals staffs were present with overload of work. The private hospital suffered a drop of-33% in attendance and-5% in monthly revenues, followed by a staff shortage. Discussion: The reforms have given confidence to public health facilities users and revealed the weak hospitals capacity and difficulties in managing patient flows and staff. Conclusion: There’s a start in improving practices for better hospital performance. Government involvement and technical platforms strengthening are crucial for sustainable results and private hospitals must recruit their own staff.},
     year = {2020}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Sectoral Effects of Public Policy Reforms in Benin: Case of the Health System
    AU  - Prince Comlan Eugene Adjovi
    AU  - Ibrahima Thiam
    AU  - Fabienne Fecher
    Y1  - 2020/09/10
    PY  - 2020
    N1  - https://doi.org/10.11648/j.hep.20200503.12
    DO  - 10.11648/j.hep.20200503.12
    T2  - International Journal of Health Economics and Policy
    JF  - International Journal of Health Economics and Policy
    JO  - International Journal of Health Economics and Policy
    SP  - 54
    EP  - 62
    PB  - Science Publishing Group
    SN  - 2578-9309
    UR  - https://doi.org/10.11648/j.hep.20200503.12
    AB  - The closure of illegal health facilities and the elimination of dual membership of health professionals have been part of health reforms since 2016 in Benin. This research was intended to deeply analyze the immediate effects of new reforms in hospitals and assess governance implications. Methods: The research was a retrospective analysis conducted by a mixed method, using both qualitative and quantitative primary data from three public hospitals and one confessional, from the national public health office and of administration and finances office. Health human resources and their complaints, attendance at health care units, monthly hospital revenues and corrupt practices were used as variables. The research covered the first semesters of 2018 and 2019. The sample was made by reasoned choice. Results: Attendance increased at public hospitals from 12% to 80% and their monthly revenues up to 200% in 2019 and hospitals staffs were present with overload of work. The private hospital suffered a drop of-33% in attendance and-5% in monthly revenues, followed by a staff shortage. Discussion: The reforms have given confidence to public health facilities users and revealed the weak hospitals capacity and difficulties in managing patient flows and staff. Conclusion: There’s a start in improving practices for better hospital performance. Government involvement and technical platforms strengthening are crucial for sustainable results and private hospitals must recruit their own staff.
    VL  - 5
    IS  - 3
    ER  - 

    Copy | Download

  • Sections