What factors influence health policy entrepreneurs in West Africa?

This paper investigates the agenda-setting criteria used by policy entrepreneurs directly involved in the implementation of user-fee abolition or reduction policies for maternal care services in Africa. The study uses an experimental technique, best-worst scaling (BWS), to identify the criteria that drive their decision making. Results suggest that political commitment and impact on health are identified as the most important criteria, while international pressure and donor money are ranked as the least important. Respondents confirm that a strong leadership role is required at the governmental level in order to effect policy change, but attribute relatively little importance in decision making for increasing equity of health care among population groups or for the ability of the health system capacity to carry out new policy.