@article{fdi:010075014,
  title = {{T}ime to abandon amateurism and volunteerism : addressing tensions between the {A}lma-{A}ta principle of community participation and the effectiveness of community-based health insurance in {A}frica},
  author = {{R}idde, {V}al{\'e}ry and {A}ntwi, {A}.{A}. and {B}oidin, {B}. and {C}hemouni, {B}. and {H}ane, {F}. and {T}our{\'e}, {L}.},
  editor = {},
  language = {{ENG}},
  abstract = {{F}orty years after the 1978 {A}lma-{A}ta declaration, the second international conference on primary health care in {O}ctober 2018 is expected to reaffirm the place of communities in health systems management and governance. {I}n parts of {A}frica, community-based health insurance ({CBHI}) - with communities at the centre - is still seen as a strategy for achieving universal health coverage ({UHC}) - but there are tensions between the {A}lma-{A}ta principle of community participation, as currently interpreted, and {CBHI}. {T}he tension relates particularly to the community's role in terms of the voluntary nature of {CBHI} membership and volunteer involvement of the community in governance andmanagement - this tension requires a rethink of the role of communities in {CBHI}. {W}e use examples of {R}wanda, {G}hana, {M}ali and {S}enegal to demonstrate the challenges associated with the place of communities in {CBHI}, and the need to reduce the role of community volunteers in {CBHI} and instead focus on professionalising management. {C}ountries that still wish to rely on {CBHI}s for {UHC} must find ways to make populations enrolment compulsory, and strengthen the professionalisation of {CBHI} management, while also ensuring that communities continue to have a place in {CBHI} governance.},
  keywords = {{RWANDA} ; {MALI} ; {GHANA} ; {SENEGAL}},
  booktitle = {},
  journal = {{BMJ} {G}lobal {H}ealth},
  volume = {3},
  numero = {},
  pages = {e001056 [7 ]},
  ISSN = {2059-7908},
  year = {2018},
  DOI = {10.1136/bmjgh-2018-001056},
  URL = {https://www.documentation.ird.fr/hor/fdi:010075014},
}