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Chapter 4 - Pharmaceuticals at the centre of health systems Complementary health care services by public, private for-profit and private not-for-profit provi- ders: Understanding the multiplicity of biomedical care services in Benin and Ghana PB1ob"p9 Y c-boR9Y Td;d Y gt4N Yu-iG Y TR99RmY gé4N YTC- obId1 Y PpaoRBrRY gh4N .-ERBBRGYl-BobRYgé4 .#4 5 ?G= /# 5 G B ! 3 ' B )?*G5D+64 *M 0#3 1!68

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9Many small health centers have obtained authorization through improper means: the

reported director is not the one who actually runs the facility, authorizations are granted to nursing care facilities or community childbirth clinics even though they offer a wider range of services and prescriptions. Some hospitalize patients without being authorized to do so; others perform deliveries without midwives on staff.

10Although Benin is involved in the implementation of Universal Health Coverage (CMU), it is

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7 i aojl i BacNafuKhieuo azKjx nfx Kan7janNs KIMa7CfA ajuANaPfl ajPanC aïFaCjhK CjABKaKnhR

Bf BafuaVjnjujhRa7fnCaea(CfgC)aKjofjR ojujxfoaKnenhKMaeuBaïa7fnCaea(xfBBA )aKjofjR ojujR page 143Régulations, Marchés, Santé | Ouidah | 2018 Chapter 4 - Pharmaceuticals at the centre of health systems xfoaKnenhKRa7 i afuKhi BJaUuacjnCa-ooieaeuBaVjnjujhManC aC eAnCaPeofAfnf KahK BacNaKnhBN CjhK CjABKa7eKai Aen BanjaKjofjR ojujxfoaKnenhKaeuBanC aexjhunanCenanC aCjhK CjABa7eK ecA anjaKs uBaenanC anfx J

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11However, having NHIS insurance coverage did not necessarily mean that all study

households used services that were covered by this insurance. This insurance also did not cover all health problems nor all types of medication. Sometimes medications were not

available at health facilities that accepted NHIS insurance and the medication was

purchased elsewhere. Many households complained about difficulty in obtaining their NHIS card. One household explained that they had not renewed their insurance coverage because of these difficulties as well as a perception that the insurance was not very useful. This insurance seemed to influence which medications were purchased. NHIS does not cover quinine syrup which some facilities reported prescribing for children with severe malaria. Injections also did not seem to be covered. One rural public facility described the care and treatments they offer as "dictated partially by insurance"'. These topics will be explored in depth with future research. Regulations, Markets, Health | Ouidah | 2018page 144 Chapitre 4 - Le médicament au centre des systèmes de santé CjABKaKnhBf BafuaihieAa3 ufuMa7 i aojl i BacNafuKhieuo Ma7CfoCaK x BanjasAeNaeal iNaKxeAA ijA afuaC eAnCaoei J Uua3i xeua-Kf6hxeManC i a7eKaujaBfPP i uo afuahK ajPaC eAnCaPeofAfnf KaeoojiBfuganj nC aKjofjR ojujxfoaKnenhKajPaCjhK CjABKJa-l ieAAManC K aCjhK CjABKaCeBaeoo KKanjanC aKex nNs KajPaPeofAfnf KJa:j7 l iManCfKa7eKaujnanC aoeK afuaÈjuja" seinx unMa-ooieMajiaVjnjujhJ ÀC aelefAecA aC eAnCaoei aK ilfo KafuanC an7jai K eioCaojhunif KaKCj7Kai xei6ecA aBfPR P i uo KJaàCena7eKaxjKnahu ts on BafKanC aBfPP i uo Kac n7 uanC ahiceuaeuBaihieAai R K eioCaKfn Kafua8CeueJaàCfA anC aei eafuaeuBaeijhuBahiceua-ooieaCeKaeacijeBaelefAecfAfnNajP siflen aC eAnCaPeofAfnf KMaC eAnCaoei afuaihieAa3i xeua-Kf6hxeaAjj6Kal iNaBfPP i unJa,eofAfR nf KanCenaei asi K unafuanCfKaihieAaei eaei axhoCaxji aCjxjg ujhKaeuBal iNa(uenfjueAfW B)

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page 147Régulations, Marchés, Santé | Ouidah | 2018 Actes électroniques, hal-01988227, Décembre 2018 Electronic Proceedings, hal-01988227, 2018, December Comité scientifique du colloque | Scientific committee Daniel Kojo Arhinful (NMIMR UGL, Ghana), Carine Baxerres (MERIT IRD, France), Laurent Brutus (DMG UN, France), Eve Bureau-Point (MERIT IRD, France), Maurice Cassier (CERMES3 CNRS, France), Alice Desclaux (TransVIHMI IRD, France), Marc Egrot (MIVEGEC IRD - UAO, Côte d'Ivoire), Habib Ganfon (FSS UAC, Bénin), Claudie Haxaire (CERMES3 UBO, France), Roch Houngnihin (DSA UAC, Bénin), Adolphe Kpatchavi (DSA UAC, Bénin), Jean-Yves Le Hesran (MERIT IRD - CERPAGE, Bénin), Stéphanie Mahamé (UAC-EHESS, Bénin), Maxima Missodey (NMIMR UGL, Ghana), Sandrine Musso (CNE AMU, France), Laurent Pordié (CERMES3 CNRS, France), Jessica Pourraz (EHESS, France), Mathieu Quet (CEPED IRD - CSSP, Inde), Kelley Sams (CNE, France), Kodjo Senah (DS UGL, Ghana) Comité d'organisation | Organisation committee Emilienne Anago (DSA UAC, Bénin), Carine Baxerres (MERIT IRD, France), Inès Boko (DSA UAC, Bénin), Moïse Djralah (DSA UAC, Bénin), Audrey Hémadou (DSA UAC, Bénin), Roch Houngnihin (DSA UAC, Bénin), Adolphe Kpatchavi (DSA UAC, Bénin), Anani Agossou (DSA UAC, Bénin), Aubierge Kpatinvoh (CERPAGE, Bénin), Jean-Yves Le Hesran (MERIT IRD, Bénin), Stéphanie Mahamé (UAC-EHESS, Bénin), Charlie Marquis (Globalmed, France), Maxima Missodey (NMIMR UGL, Ghana)

Comité éditorial | Editorial board

Carine Baxerres (MERIT IRD, France), Eve Bureau-Point (MERIT IRD, France), Alice Desclaux (TransVIHMI IRD, France), Habib Ganfon (FSS UAC, Bénin), Claudie Haxaire (CERMES3 UBO, France), Jean-Yves Le Hesran (MERIT IRD - CERPAGE, Bénin), Stéphanie

Mahamé

(UAC-EHESS, Bénin), Charlie Marquis (Globalmed, France), Maxima Missodey (NMIMR UGL, Ghana), Sandrine Musso (CNE AMU, France), Jessica Pourraz (EHESS, France), Mathieu Quet (CEPED IRD - CSSP, Inde), Kelley Sams (CNE, France), Kodjo

Senah (DS UGL, Ghana)

page 3Régulations, Marchés, Santé | Ouidah | 2018CC-BY.ERC-Globalmed

CC-BY.ERC-Globalmed

Ce colloque était organisé par l'équipe du programme de recherche Globalmed financé par l'European Re-

search Council dans le cadre du 7ème programme cadre de l'Union Européenne (FP7/2007-2013) /

ERC grant agreement n°337372 et porté conjointement par l'unité MERIT de l'Institut de Recherche pour

le Développement (France), Le CERMES3 (France), le Noguchi Memorial Institute for Medical Research

(Ghana), le Département de Sociologie-Anthropologie de l'Université Abomey-Calavi (Bénin) et l'Universi-

té des Sciences de la Santé (Cambodge). Le colloque s'est tenu grâce aux partenariats scientifiques sui-

vants : TransVIHMI, CNE, CERPAGE, LAMA, EHESS et l'Université Paris Descartes. D'importants soutiens

ont aussi émané de l'Institut de Recherche pour le Développement, de l'Organisation Mondiale de la San-

té, de l'Université d'Abomey-Calavi, de l'Institut Régional de Santé Publique de Ouidah au Bénin et des

Ambassades de France au Bénin et au Ghana..

This symposium was organized by the team of Globalmed Project, funding from the European Research Council under the European Union's Seventh Framework Programme (FP7/2007-2013) / ERC grant

agreement n°337372, jointly carried by MERIT unit from National Research Institute for Sustainable De-

velopment - IRD (France), The CERMES3 (France), the Noguchi Memorial Institute for Medical Research

(Ghana) and the Applied Medical Anthropology Laboratory -LAMA (Benin) and the Life Sciences University

(Cambodia). The symposium was supported by scientific partnership with : the TransVIHMI, the CERPAGE and the MIVEGEC (IRD), the CERMES3 (CNRS), the EHESS, the Universities of Abomey-Calavi, Ghana Le-

gon and Paris Descartes. Moreover, the French National Research Institute for Sustainable Development,

the European Research Council, the World Health Organisation, the Abomey-Calavi University, the Regio-

nal Institut of Public Health of Ouidah and the french embassies in Benin and in Ghana have been given

important supports. Regulations, Markets, Health | Ouidah | 2018page 4quotesdbs_dbs25.pdfusesText_31

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