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This article analyses the efficiency of the two main health policies implemented in Burkina Faso: the primary health care (PHC) & and Bamako initiative. The analysis uses the results of two regional studies & a national documentary survey. The efficiency of these two policies is doubtful; neither allowed, despite a major public financial investment, an improvement of access to health care. In order to understand the relative ineffectiveness of these policies in Burkino Faso, it is urgent to study the interaction of the principal actors in their implementation. 5 Tables, 2 Figures, 50 References. [Copyright 2003 Sage Publications Ltd.]

The effects of an assault on health care in the Congo.
In an environment of general shortages what happens when there are suddenly abundant supplies ? The effects of an operation of increased medical supplies staged in the Congo are analyzed. The impact on health care is examined alongside the effects on the functioning of the health care system as a whole and the attitudes of both the professionals and the populations involved.

Health care and health insurance.
The author shows how health care austerity policy and the social security crisis have given rise to an added mission for national health insurance (NHI) bodies which, since 1980, have had to evaluate the functioning of the health care System and contribute to improving its efficiency in addition to their current tasks. She describes the history of NHI duties and recent developments in various health care sectors, including private practise and hospital care, public and private. The missions of ail bodies are given. The new powers vested in Social Security are part of long-term government policy ; government instruments of self-regulation are analyzed ; the specific role of Social Security is described in detail, i.e. how it maintains ongoing dialogue towards negotiated change with health care professionals, over and above authoritarian regulations and economic restrictions. In fact, the State relies on NHI to adjust societal regulations so as to try to build a consensus for its policy. The proper execution of this new function assumes a re-distribution of roles among individuals and bodies active in NHI. This would modify the configuration of an already complex power structure. The article also describes the problems arising within NHI from the growing importance of Consulting physicians.