The politics of the health district reform in the Republic of Benin

The analysis of health policy reform focuses mostly on the contents of reforms. Walt and Gilson (1994) draw attention to the fact that the environmental context as well as the actors involved are of crucial importance to the process of policy adoption. This paper describes and analyses the process of adoption of the new concept of so-called 'sanitary zones' in the Republic of Benin as part of the health sector reform. The analysis of the reform is based on the examination of documents and interviews carried out in Benin in February 1997. The main findings show that the reasons for the specific policy choice do not emerge clearly. The main problems identified are: the role of the hospital, the incongruous administration, resistance against the reform and the question whether the government actually has the political will to change. Possible solutions to these constraints are offered in the conclusion. (C) 1998 John Wiley & Sons, Ltd.