PP28: Are policy reforms enough to improve satisfaction with health care? Evidence from Benin


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Policy papers
Richard Houessou

In 2009, the government of Benin embarked on a series of policy initiatives to increase public access to health services, especially for pregnant women, children under age 5, and the poor.

While health coverage rates remained steady, attendance at health services increased sharply, and at first, public satisfaction with the government’s performance in improving basic health services increased as well. However, by 2014, public approval of the government’s efforts had dropped sharply. What explains this decrease in public satisfaction, despite the policy reforms?

This paper uses Afrobarometer survey findings and other data to examine mechanisms that might contribute to dissatisfaction at the grass roots with how government is handling health services. Its finding that citizens’ negative experiences while visiting public clinics or hospitals are the main factor driving down public assessments of government performance in this area should alert policy makers that they must put in place more than policy reforms in order to satisfy public demand for high-quality basic health services.