Role of cost sharing on quality of health care: community and patients perceptions in Bagamoyo district

A cross-sectional study was conducted in Bagamoyo with the objectives of investigating the influence of the introduction of user fee on the quality of health care services. The study subjects included 300 community members, 52 health workers and 184 patients. Data was collected using structured interview schedule and key informants guidelines. The level of satisfaction with the health services was 86.4% among patients interviewed. Over a half 65.4% of community subjects perceived that there had been very little improvement in the structure of buildings. Overall, 45% of the community subjects mentioned that they would not be willing to pay more money as user fee. Fifty four point nine per cents (54.9%) of the patients interviewed reported short distance as the main reason for choice of district hospital and 72.4% of those who reported to have used other health facilities mentioned closeness to ones’ home as the main reason. Drug availability as reported by 57.7% community, 63.7% patients and 57.7% health workers, they said that the last month purchase do not last for the whole month.