“Out-of-Pocket Expenditure”, Abolition User Fees and the Quality of Health Services Provided by Public Health Centers IVs in Uganda: A Case of Health Centre IVs in Rujumbura Health Sub District; Rukungiri

Authors

  • Dr. Nsambu Kijjambu F. Mbarara University of Science and Technology
  • Dr. Baguma Kule John Mbarara University of Science and Technology
  • Asaph Katarangi K. Mbarara University of Science and Technology
  • Tumwebembaire N. Mbarara University of Science and Technology

DOI:

https://doi.org/10.47672/ejhs.1472
Abstract views: 105
PDF downloads: 94

Keywords:

Out-of-Pocket Expenditure; Cost Efficiency New Technology

Abstract

Purpose: The study intended to investigate inadequate health financing as challenge in Uganda, the study population included residents of Rujumbura Health sub district in Rukungiri who have lived in the place for a period exceeding fifteen years, being served by Bugangari and Buhunga Health center IVs. The study was guided by the following specific objectives; to establish whether there is no longer “out of pocket expenditure” in public health centers IVs in Uganda; To establish the effect of “out-of-pocket expenditure” on the quality of health services provided by public health centers IVs in Uganda.to establish the effects of abolishing user fees on the quality of health services provided by public health centers IVs in Uganda.

Methodology: It was a cross-sectional study, which was inclined to quantitative approaches

Findings: The study findings indicated that there is a positive relationship with out of pocket expenditure and the quality of health services provided however, results in the model summary concludes that ‘out of pocket expenditure explain 38.9% of the changes in quality of health services and the remaining 61.1% may be explained by other factors consistent with the overall effect of abolishing “out of pocket” expenditure in the study area. 

Recommendations: The policy implication emerged from this study indicates that the quality of health services will be at optimum if users’ fees are in order to foster further improvement rather than abolishing user fees in health center IVs at a reasonable amount which is affordable by citizen. Especially aby adopting private and user free wings. More Qualified medical officers should be deployed at these levels to increase on the image of health center IVs, purposely to increase the confidence and trust by patients to medical officers when they are being treated. A policy on out of pocket expenditure is crucial in improving on cost efficiency and to protect “patients “New technology” in the hospital should be adopted in these health center IVs to improve on the corporate images of these health facilities and also to provide appropriate diagnosis and prescription. Information on hospital rules, regulations and procedures should be provided and can easily be accessible at the hospital and even before. Further studies should be carried out to establish the optimum adequate out of packet expenditure to be charged to the patients at respective health facilities in the country for particular illness and consultation

 

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Author Biographies

Dr. Nsambu Kijjambu F., Mbarara University of Science and Technology

 

 

Dr. Baguma Kule John, Mbarara University of Science and Technology

 

 

Asaph Katarangi K., Mbarara University of Science and Technology

 

 

Tumwebembaire N., Mbarara University of Science and Technology

 

 

References

Akashi, H T Yamada et al (2004). User fees at public hospital in Cambodia: effects on hospital performance and provider attitudes Soc. Sci. Med 58(3): 532-8

Barber, S.F Bonnet et al (2004). Formalizing under the table payments to control out of pocket hospital expenditures in Cambodia health policy Plan19(4): 199-208

Collins D, Quick et al (1996) ‘The fall and rise of cost sharing in Kenya: the impact of phased implementation.” Health policy Plan 11(1): 52-63

Chawla, M and Ellis R.P (2000) The impact of financing and Quality changes on health care demand in Niger health Policy Plan 15(1): 76-84

Diop f a Yazbec (1995) The impact of alternative cost recovery schemes on access and equity in Niger. Health policy plan 10(3): 223-40

Doiron, D., Jones, G., Savage, E., 2008. Healthy, wealthy and insured? The role of self-assessed health in the demand for private health insurance. Health Economics 17, 317-334

Haddad S and Fournier P (1995) Quality, cost and utilization of health services in Developing countries. A longitudinal study in Zaire Soc Sci Med40(6): 743-53

Hussein A.K and Mujinja P.G (1997) “Impact of user charges on government health facilities in Tanzania.”East Africa medical journal 74(12): 751-7

James C Kara H; Mcpake B; Balabanova D; Gwatkin D; Hopwood I; Kirunga C; Knippenberg R; Meessen B; Morris SS; Preker A; Soucat A; Souteyrand Y; Tibout a; Villeneuve and Xu,(2006)To retain or remove User fees; Reflection on the current debate; Appl health econ health policy 2006; 5(3):137-53Pub med Us national library

Kipp W and Kamugisha J(2001) “User fees , health staff incentives and health utilization in Kabarole District, Uganda” Bull world health Organ 79(11): 1032-7

Liu, X and A Mills (2002) Financing reforms of public health services in China: Lessons for other nations Soc Sci Med 54(11): 310-21

Litvack, Ji and C Bodart (1993). User fees plus quality equals improved access to health care: results of a field experiment in Cameroon soc sci med 37(3): 369-83

Masiye F, Chitah BM, Chanda P and Simeo F (2008) ‘Removal of user fees at primary Health care facilities in Zambia: A study of the effects on utilization and quality of care’, Equinet discussion paper series 57 Equinet,UCT,HEU: Harare

Mbugua J.K Bloom et al (1995) Impact of user charges on vulnerable groups: the case of Kibwezi in rural Kenya Soc Sci Med 41 (6): 829-35

Morestin F and Ridde v (2009); The abolition of user fees for health services in Africa lessons from the Literature, university de Montreal, Canada

Nabyonga J. Karamagi H Atuyambe L Bagenda F; Okuonzi and Oladapo W (2008) Maintaining quality of health services after abolition of user fees: a Uganda case, BMC Health services Research,2008, 8(1): pp102.

Nabyonga JE; Mugisha F; Kirunga C; Macq J; Bart C (2011) Strengthen health systems; Abolition of user fees: the Uganda paradox; World health organization Uganda office; Health Systems Unit, Kampala, Uganda.

Nguyen, Ha and Connelly, Luke B. (2017): Cost-sharing in health insurance and its impact in a developing country– Evidence from a quasi-natural experiment. Online at https://mpra.ub.uni-muenchen.de/76399/ MPRA Paper No. 76399, posted 25 Jan 2017 13:45 UTC

Nyende M; Guloba M; Wokadala W (2010); Public spending in the health sector in Uganda: Evidence from program budgeting analysis: Final paper submitted to the global development network June, 2010

Ridde V.(2003) “Fees –for services, cost recovery and equity in district of Burkina Faso operating the Bamako Initiative. Bull world health organ81 (7):532-8

Soucat A T Gandaho et al (1997) Health seeking behaviour and household health expenditure in Benin and Guinea: the equity implementations of the Bamako Initiative. International journal health planning Management 12 Supplementary 1: S137-63

Uganda Parliamentary committee (2012); Report of the parliamentary committee on health on the ministerial policy statement for the health sector for the financial year 2012/2013

Uzochukwu B O Onwujekwe (2004). Inequity in Bamako initiative Programme- Implications for the treatment of malaria in South-East Nigeria.” International journal of health planning and management 19Suppl 1: S 107-16

World Health Organization (2005) The elimination of user fees in Uganda: impact on utilization and catastrophic health expenditures; discussion paper number 4, 2005

World bank (1987) Financing health services in developing countries: an Agenda for reform. Washington DC

World health organization/Rukungiri district, 2001; Evaluation of the Bamako Initiative scheme in Rukungiri district. Kampala: Ministry of Health

Zigora T. (1996) An evaluation of abolition of user fees at rural health service centers and rural hospitals. Harare, Zimbabwe, Blair laboratory for Ministry of Health

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Published

2023-05-22

How to Cite

Kijjambu F., D. N. ., Kule John, D. B. ., Katarangi K., A. ., & N., T. (2023). “Out-of-Pocket Expenditure”, Abolition User Fees and the Quality of Health Services Provided by Public Health Centers IVs in Uganda: A Case of Health Centre IVs in Rujumbura Health Sub District; Rukungiri. European Journal of Health Sciences, 9(1), 43 - 62. https://doi.org/10.47672/ejhs.1472

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