ABSTRACT
For many years the cost of health care in sub-Saharan Africa was largely covered by the State. But in September 1987, in view of the economical problems those countries had to face, the WHO regional committee adopted the "Bainako's Initiative" resolution. This meant that from then on everybody was to pay for their health expenses. The purpose of this prospective study which was conducted from March 1, 1996 to February 28, 1999 among 316 patients was to assess hospitalization charges incurred for patients in the Neurology Department of Lomé Teaching Hospital with a view to improve the quality of the services provided and the accessibility of care. A questionnaire was used and every expense relating to the hospitalization of each patient was recorded on a daily basis. The average cost is 389,586 (48,485 FCFA for an average stay of 19.7 (2.5 days. This average cost is 19 times the minimal monthly salary of a state employee. It can be broken down as follows: Accommodation costs represent 52%, medical acts and tests 20.3% while drug costs amount to 21.2% and accompanist expenses represent 6.5%. The average cost of HIV-infected patients is 635,017 (190,624 FCFA for an average stay of 57 (12.9 days. The average cost of HIV-negative patients is 257,354 (12,837 FCFA for an average stay of 24.4 (1.8 days. To improve the quality of the services and the accessibility of care, it is necessary to prescribe and make drugs available in their generic form. After a few days in hospital, some disabling diseases as strokes, myelopathy and myopathy should be treated at home to reduce the length of stay in hospital or in cheaper places such as prolonged accommodation centres.
