Equity and Access to Quality Care in Urban Areas: Urban Health Project

The Urban Health Project, which began in 1997 in 5 capitals of Francophone West Africa (Abidjan, Bamako, Conakry, Dakar and Niamey), was the fruit of collaboration between UNICEF, the French Cooperation and the five countries concerned. This Project, which primarily aims to improve access to quality health care in urban areas, especially for the poor, was staggered in three phases: i) an action-research phase; ii) an operationalization phase; iii) a final evaluation phase.

This regional report provides a synthesis of:
• the studies of the 3 components of the action-research phase, (socioeconomic, socioanthropological and quality of care),
• complementary missions on the operation of the urban health system and the structural
quality of health services, conducted in three of the five capitals,
• a review of the literature on quality, equity and efficiency of care in urban areas on the
continent.

The document was designed in a simple and practical way for easy reading, highlighting major observations that could be corrected in the future, with the adoption of appropriate operational strategies. The strategies proposed for improving the quality and equity of care in urban areas are not only based on the findings of the Project studies, but also on promising experiences initiated in some countries in the sub-region, in the context of the health system reform. In fact, they constitute a Minimum Package of indispensable operational strategies for improving access to quality care in urban health centres, notably for disadvantaged people. Sooner or later, all the countries will have to adopt these strategies. Differences between countries will relate to the process of implementation which will vary according to the specific context. Often, the implementation will require an in-depth reform of the health sector.

Under the operationalization phase of the project, the various parties involved will have to select strategies, from those to be adopted in a conceptual manner, that are likely to be financed, on the basis of criteria to be defined.

The present report should be perceived as synthesis on which will ve bared the drafting of preparatory documents of the closing Forum of the action-research phase.