The equity impacts of community financing activities in three African countries

Although the Bamako Initiative from its very beginning was caught up in wid er debates about the potential equity impact of any form of user financing, to date there has been little empirical investigation of this impact. This three-country study, undertaken in Benin, Kenya and Zambia in 1994/95, was initiated to add to the body of relevant evidence. It sought to understand not only what had been the equity impacts of community financing activitie s in these countries but also how they had been brought about. As a result, it investigated equity primarily through consideration of the design of th ese financing activities and through the perceptions of different actors, w ithin a limited number of purposively selected geographical areas in each c ountry, about their strengths and weaknesses. Additional data on utilizatio n were either collected during the course of the study (Kenya) or drawn fro m other available studies (Benin and Zambia). Key issues considered in the studies' assessment of equity were the extent to which both relative and ab solute affordability gains were achieved, as well as as an influence over b oth the distributional and procedural justice of the financing activities, the pattern of decision-making. Across countries there was evidence of rela tive affordability gains in Benin and Kenya, but Kenyan gains were not sust ained over time and no such gains were identified in Zambia. In addition, n o country had given attention either to the issue of absolute affordability , through the implementation of effective exemption mechanisms to protect t he poorest from the burden of payment, or to the establishment of community decision-making bodies that effectively represented the interests of all g roups including the poorest. Overall, therefore, although the Benin Bamako Initiative programme might be judged as successful in terms of what appear to be its own equity objectives, the other two countries' schemes had clear equity problems even in these terms. The experience across countries also highlights the unresolved question of whether equity is concerned with the greatest good for the greatest number or with promoting the interests of th e most disadvantaged. Copyright (C) 2000 John Wiley & Sons, Ltd.