PS 01-1 User fees Za - African Health Economics and Policy PS 01-1用户收费的ZA—非洲健康经济学与政策.pptVIP

* User fee removal in Zambia: What happened and what was the impact?A community focused study AfHEA Conference Accra, Ghana !0th-12th March 2009 Mary Hadley, Lead Researcher Collins Chansa, Ministry of Health * Outline Objectives of the study Methods Implementation of policy Potential impact on health of population -who attends? -what they get? -did they follow advice? Conclusion * Objectives of qualitative component Qualitative component of the User Fee Evaluation was designed to: Inform the wider research protocol design Assist with interpretation of the results Explore in more depth areas that are not easy to investigate using quantitative methods * Methods (1) A team of international and national researchers Interviews n=(99), discussions (n=23) and observations (n=14) Key informants Users, non users, health providers and community volunteers and committee members participated. Discussion in a rural area with Neighbourhood Health Committee members * Sites selected Government Faith-based/NGO Rural Urban Hospitals 5 3 user fees 2 fees removed 2 Both fees removed (3) (4) Health Centres 15 8 user fees 7 fees removed 3 1 user fees 1 fees removed 1 NGO (5) (13) 8 user fees, 4 fees removed ‘07 1 NGO Total 20 5 (8) (17) Total facilities n=25 Charging User Fees n=12 +1 (NGO) User Fees Removed n=12 Facilities close to the border n=4 * Methods (2) Building on existing information, three broad questions were used as the framework for data collection. Data generated was triangulated for validation purposes and themes identified What do people do when they get sick? What happens if they go to a health facility? What do they do when they get home? * Implementation of policies * Cost sharing policy Community involvement in setting and using user fees was patchy Exemption policy for categories such as under 5s and over 65s and to some extent chronic conditions