Health sector reform in Mali, 1989-1996 - TropMed Central Antwerp ...
Health sector reform in Mali, 1989-1996 - TropMed Central Antwerp ...
Health sector reform in Mali, 1989-1996 - TropMed Central Antwerp ...
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102<br />
Figure 20. Depreciation and devaluation: effects on the f<strong>in</strong>ancial equilibrium of a rural<br />
ComHC<br />
FCFA<br />
500.000<br />
400.000<br />
300.000<br />
200.000<br />
100.000<br />
-100.000<br />
-200.000<br />
-300.000<br />
-400.000<br />
-500.000<br />
Studies <strong>in</strong> HSO&P,20,2003<br />
0<br />
10% 15% 20% 25% 30% 35%<br />
Usage rate<br />
Before devaluation Depreciation 1 Depreciation 2 Depreciation 2 + FCFA 50<br />
Note: ComHC with a population of 9,631 <strong>in</strong>habitants of which 55% live with<strong>in</strong> 5 km of<br />
the health centre. Depreciation accru<strong>in</strong>g to ComHC: Depreciation 1 = refrigerator<br />
over five years, small tools over three years, mobilette over three years. Depreciation 2<br />
= small tools over three years, mobilette over three years. Option = rate <strong>in</strong>crease of<br />
FCFA 50.<br />
F<strong>in</strong>anc<strong>in</strong>g the district health system<br />
In the districts where a cost-recovery system was organized, close to 50% of<br />
the operat<strong>in</strong>g budget came from local revenue, with the State cont<strong>in</strong>u<strong>in</strong>g to<br />
pay salaries. The non-functional health areas were and rema<strong>in</strong> covered by<br />
the SDHCs, at least for preventive care. For this the R-SDHC receives a<br />
modest subsidy. In the framework of the new programme, the State needed<br />
to <strong>in</strong>crease the health portion of the State budget from 4% <strong>in</strong> 1991 to 9% <strong>in</strong>