[The Bamako initiative: hope or illusion? Observations on the Benin experience]

In various countries in Africa, community financing has become the main source of finance for health services. In Benin, the "Bamako Initiative" experiment started in 1988 for many health structures and has subsequently been greatly expanded. After three years experience, the authors try to answer some important questions about community financing: To what extent does payment of fees have an influence on the use of health services? How are the funds collected and used and is embezzlement a serious problem? The question of equity is also considered as well as cost recovery, allowing an economics-based assessment of the Bamako Initiative which suggests that it has a promising future in Benin.