The impact of user fees on utilization of Public Health Services in Dar es Salaam city: a case of the urban poor in Manzese ward.
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Date
2001
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Publisher
University of Dar es Salaam
Abstract
Since the early 1980s Tanzania has been experiencing a severe economic crisis contributing towards the falling standard of living and quality of life of the majority of the population. Structural Adjustment Programmes were adopted to arrest the situation. However, the socio-economic impact of this policy in different sectors, including health has not been fully unraveled. This research study on the impact of user fees on utilization of public health services amongst poor was proposed as a response to the afore said problem. Our objectives were to examine:- influence of user fees on choice of treatment facilities factors influencing people's willingness to pay for cost of medical care in public health facilities, and peoples' income and corresponding ability to meet cost of public health care. Baseline data from 120 respondents obtained from the densely populated Manzese ward in Dar es Salaam region has been used to ascertain these objectives and the stated hypothesis. Results show a variety of health providers across the study area differing in terms of cost, expertise, accessibility and quality. Yet, Public health facilities are reported to be a source of medical care for more than 90% of the users. Evidence suggests that income is the major factor in the choice of health facilities. This is signified by the proliferation of use of traditional medicine, self-medication, and faith healing among the low-income households. Both income of the user and quality of the services influenced willingness to pay for medical care. The study recommends a clear trade-off between the provision of medical care and charging user fees so that a positive correlation between these variables is established. Deliberate effort to alleviate poverty ought to be the major goal for the country's development agenda.
Description
Available in print form, East Africana Collection, Dr. Wilbert Chagula Library, Class mark (THS EAF RA552.T34M49)
Keywords
Public health, Public health finance, Public health administration, Tanzania
Citation
Metta, E. (2001). The impact of user fees on utilization of Public Health Services in Dar es Salaam city: a case of the urban poor in Manzese ward. Master dissertation, University of Dar es Salaam.