Discontinuation of cost sharing in Uganda
OBJECTIVE: To assess the effects of ending cost sharing on use of outpatient services and how this was perceived by health workers and members of a health unit management committee. METHODS: From 10 districts across Uganda, 78 health facilities were selected. Attendance at these facilities was asses...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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The World Health Organization
2004-01-01
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| Series: | Bulletin of the World Health Organization |
| Subjects: | |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862004000300008 |
| _version_ | 1827336593598316544 |
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| author | Burnham Gilbert M. Pariyo George Galiwango Edward Wabwire-Mangen Fred |
| author_facet | Burnham Gilbert M. Pariyo George Galiwango Edward Wabwire-Mangen Fred |
| author_sort | Burnham Gilbert M. |
| collection | DOAJ |
| description | OBJECTIVE: To assess the effects of ending cost sharing on use of outpatient services and how this was perceived by health workers and members of a health unit management committee. METHODS: From 10 districts across Uganda, 78 health facilities were selected. Attendance at these facilities was assessed for eight months before and 12 months after cost sharing ended. The data represented 1 966 522 outpatient visits. Perceptions about the impact of ending cost sharing were obtained from the 73 health workers and 78 members of the health unit management committee who were available. FINDINGS: With the end of cost sharing, the mean monthly number of new visits increased by 17 928 (53.3%), but among children aged <5 years the increase was 3611 (27.3%). Mean monthly reattendances increased by 2838 (81.3%) among children aged <5 years and 1889 (24.3%) among all people. Attendances for immunizations, antenatal clinics, and family planning all increased, despite these services having always been free. Health workers reported a decline in morale, and many health unit management committees no longer met regularly. CONCLUSION: Use of all services increased - even those that had never before been subject to fees. The loss of some autonomy by the health facility and diminished community governance of health facilities may have long term negative effects. |
| first_indexed | 2024-03-07T18:33:59Z |
| format | Article |
| id | doaj.art-521d8c21389d45d080cf462f29aa131c |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T18:33:59Z |
| publishDate | 2004-01-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-521d8c21389d45d080cf462f29aa131c2024-03-02T05:06:32ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862004-01-01823187195Discontinuation of cost sharing in UgandaBurnham Gilbert M.Pariyo GeorgeGaliwango EdwardWabwire-Mangen FredOBJECTIVE: To assess the effects of ending cost sharing on use of outpatient services and how this was perceived by health workers and members of a health unit management committee. METHODS: From 10 districts across Uganda, 78 health facilities were selected. Attendance at these facilities was assessed for eight months before and 12 months after cost sharing ended. The data represented 1 966 522 outpatient visits. Perceptions about the impact of ending cost sharing were obtained from the 73 health workers and 78 members of the health unit management committee who were available. FINDINGS: With the end of cost sharing, the mean monthly number of new visits increased by 17 928 (53.3%), but among children aged <5 years the increase was 3611 (27.3%). Mean monthly reattendances increased by 2838 (81.3%) among children aged <5 years and 1889 (24.3%) among all people. Attendances for immunizations, antenatal clinics, and family planning all increased, despite these services having always been free. Health workers reported a decline in morale, and many health unit management committees no longer met regularly. CONCLUSION: Use of all services increased - even those that had never before been subject to fees. The loss of some autonomy by the health facility and diminished community governance of health facilities may have long term negative effects.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862004000300008Ambulatory care/economicsCost sharingHealth services/utilizationHealth services accessibilityPharmaceutical preparations/supply and distributionUganda |
| spellingShingle | Burnham Gilbert M. Pariyo George Galiwango Edward Wabwire-Mangen Fred Discontinuation of cost sharing in Uganda Bulletin of the World Health Organization Ambulatory care/economics Cost sharing Health services/utilization Health services accessibility Pharmaceutical preparations/supply and distribution Uganda |
| title | Discontinuation of cost sharing in Uganda |
| title_full | Discontinuation of cost sharing in Uganda |
| title_fullStr | Discontinuation of cost sharing in Uganda |
| title_full_unstemmed | Discontinuation of cost sharing in Uganda |
| title_short | Discontinuation of cost sharing in Uganda |
| title_sort | discontinuation of cost sharing in uganda |
| topic | Ambulatory care/economics Cost sharing Health services/utilization Health services accessibility Pharmaceutical preparations/supply and distribution Uganda |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862004000300008 |
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