Impact of user fees removal on facility utilisation in rural Zambia

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dc.contributor.advisorThiede, Michaelen_ZA
dc.contributor.advisorGovender, Veloshneeen_ZA
dc.contributor.authorBanda, Patricken_ZA
dc.date.accessioned2014-11-09T15:52:11Z
dc.date.available2014-11-09T15:52:11Z
dc.date.issued2008en_ZA
dc.descriptionIncludes bibliographical references (leaves 96-105).en_ZA
dc.description.abstractUser fees were introduced in Zambia as an additional source of revenue in response to the economic down-turn that the country experienced in the early 1990s. There is increasing evidence that user fees are a major barrier to accessing health services especially for the poor and in response the Zambian government abolished user fees in all public health facilities in rural based districts in April 2006. The aim of this study is to provide empirical evidence on the immediate impact of the abolition of user fees in the context of the Zambian health sector so as to identify optimal strategies in the delivery of health care. Both qualitative and quantitative data collection techniques were used to address the research objectives. The study focused on six 6 health facilities in two rural districts. The data collection tools included utilisation data reviews, patient exit polls, providers interviews, focus group discussions, informant interviews and drug availability data reviews. The results demonstrated that, the impact of the abolition of user fees at the district level was dependent on location of the district. Information flow was mainly cited as one of the reasons for the quick response to the user fee policy change. This brings in the need for a more deliberate and appropriately managed communication process when such policy change is being planned. The results of the study revealed that there was an impact on facility utilisation after the removal of user fees. In addition, there were shortages of drugs, low staff morale and poor maintenance of the surroundings. Patient-provider relationships seemed to be strained as a result of the increase in provider workload.en_ZA
dc.identifier.apacitationBanda, P. (2008). <i>Impact of user fees removal on facility utilisation in rural Zambia</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit. Retrieved from http://hdl.handle.net/11427/9455en_ZA
dc.identifier.chicagocitationBanda, Patrick. <i>"Impact of user fees removal on facility utilisation in rural Zambia."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2008. http://hdl.handle.net/11427/9455en_ZA
dc.identifier.citationBanda, P. 2008. Impact of user fees removal on facility utilisation in rural Zambia. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Banda, Patrick AB - User fees were introduced in Zambia as an additional source of revenue in response to the economic down-turn that the country experienced in the early 1990s. There is increasing evidence that user fees are a major barrier to accessing health services especially for the poor and in response the Zambian government abolished user fees in all public health facilities in rural based districts in April 2006. The aim of this study is to provide empirical evidence on the immediate impact of the abolition of user fees in the context of the Zambian health sector so as to identify optimal strategies in the delivery of health care. Both qualitative and quantitative data collection techniques were used to address the research objectives. The study focused on six 6 health facilities in two rural districts. The data collection tools included utilisation data reviews, patient exit polls, providers interviews, focus group discussions, informant interviews and drug availability data reviews. The results demonstrated that, the impact of the abolition of user fees at the district level was dependent on location of the district. Information flow was mainly cited as one of the reasons for the quick response to the user fee policy change. This brings in the need for a more deliberate and appropriately managed communication process when such policy change is being planned. The results of the study revealed that there was an impact on facility utilisation after the removal of user fees. In addition, there were shortages of drugs, low staff morale and poor maintenance of the surroundings. Patient-provider relationships seemed to be strained as a result of the increase in provider workload. DA - 2008 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2008 T1 - Impact of user fees removal on facility utilisation in rural Zambia TI - Impact of user fees removal on facility utilisation in rural Zambia UR - http://hdl.handle.net/11427/9455 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/9455
dc.identifier.vancouvercitationBanda P. Impact of user fees removal on facility utilisation in rural Zambia. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2008 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/9455en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherHealth Economicsen_ZA
dc.titleImpact of user fees removal on facility utilisation in rural Zambiaen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPHen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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