caa a22 4500 397520093 CHVBK 20180308164630.0 cr unu---uuuuu 161202e199509 xx s 000 0 eng 10.1093/heapol/10.3.257 doi (NATIONALLICENCE)oxford-10.1093/heapol/10.3.257 WOUTERS ANNEMARIE Abt Associates Inc. Improving quality through cost recovery in Niger [Elektronische Daten] [ANNEMARIE WOUTERS] New evidence on the quality of health care from public services in Niger is discussed in terms of the relationships between quality, costs, cost-effectiveness and financing. Although structural attributes of quality appeared to improve with the pilot project in Niger, significant gaps in the implementation of diagnostic and treatment protocols were observed, particularly in monitoring vital signs, diagnostic examination and provider-patient communications. Quality improvements required significant investments in both fixed and variable costs; however, many of these costs were basic input requirements for operation. It is likely that optimal cost-effectiveness of services was not achieved because of the noted deficiencies in quality. In the test district of Boboye, the revenues from the copayments alone covered about 34% of the costs of medicines or about 20% of costs of drugs and administration. In Say, user fees covered about 50-55% of the costs of medicines or 35-40% of the amount spent on medicines and cost-recovery administration. In Boboye, taxes plus the additional copayments covered 120-180% of the cost of medicines, or 75-105% of the cost of medicines plus administration of cost recovery. Decentralized management and legal conditions in the pilot districts appeared to provide the necessary structure to ensure that the revenues and taxes collected would be channelled to pay for quality improvements. © 1995 Oxford University Press Overview nationallicence Health Policy and Planning Oxford University Press 10/3(1995-09), 257-270 0268-1080 10:3<257 1995 10 heapol https://doi.org/10.1093/heapol/10.3.257 text/html Onlinezugriff via DOI 1 other jats NATIONALLICENCE 856 40 https://doi.org/10.1093/heapol/10.3.257 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- WOUTERS ANNEMARIE Abt Associates Inc NATIONALLICENCE 773 0- Health Policy and Planning Oxford University Press 10/3(1995-09), 257-270 0268-1080 10:3<257 1995 10 heapol Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford