A comparative study of the impact of user fees on public health care utilization in Tanzania

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University of Dar es Salaam
In the absence of effective exemption policies or other forms of financial protection, user fees price the poor out of the market for health care with potentially disastrous consequences for their health status. This study was conducted to investigate the comparative impacts of user fees in public health care utilization, comparing urban and rural settings in Moshi district Tanzania. The study is prompted by the mix outcome from the previous studies, some concluding that user fees has resulted in to the decline of service utilization, while others maintaining that user fees does not affect attendance or pattern of public health care utilization. The study uses secondary data from the district hospital and primary data collected over a period of two months, January to March 2005. The collected data was analyzed using SPSS package entitled descriptive statistics including frequencies, and cross tabulation. Multinomial logistic econometric technique was also used to test the significance of user fees and other demand variables. The study established among others that user fees though it has favorable impact on quality, but it adversely affects the rural setting unlike their urban counterparts. Since Tanzania’s policy for health care aimed at equity, universal access and affordability, it is imperative for the government to re-work on its policy on user fee to achieve health care objectives. This requires formulation of viable programmes to lift the rural population from poverty, together with substantial improvement in quality of primary health care services, which mostly serve the rural setting.
Available in print form, East Africana Collection, Dr. Wilbert Chagula Library, Class mark (THS EAF RA971.3.T34S26)
Public health, Fees
Sang’enoi, A.C (2006) A comparative study of the impact of user fees on public health care utilization in Tanzania, Master dissertation, University of Dar es Salaam. Dar es Salaam.