An assessment of the significance of user fee payments for health care utilization in Tanzania a case of Misungwi district, Tanzania

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University of Dar es Salaam
Since the early 1980‘s, Tanzania has been experiencing severe economic crises that have led to the fall of living standard of most people in the country. Structural Adjustment Programmes were adopted to curb down the situation, and one of the areas of concentration was the health sector, whereby various fees have been introduced to finance health care provision in the country. Nonetheless, there are concerns as to whether user fees in health facilities are the appropriate means of improving health care utilization or not. Hence, this study examined the impact of fees on the quality of health services provided, together with the evaluation of the level of fees* affordability to in/outpatients in Misungwi District. Finally, the study tried looking at one of the intervening measures against user fee payments for health care services, which is user fee exemption. The study involved 274 respondents-both men and women. It used cross sectional design in which both primary and secondary data were collected. Primary data were collected by using questionnaires and interviews, while secondary data were obtained by documentary reviews. The collected data were entered in the Statistical Package for Social Sciences (SPSS) version 16.0. Through SPSS univariate analysis was applied to describe the frequency of occurrence of a particular variable. It was very difficult to get a particular variable that aggregates the indicators of quality of health care; instead proxies were used to explain what quality in health care is. With respect to quality, the findings of the study revealed that revenue from the paid user fees had little to do with the improvement of the quality for health care. Moreover, it was found that, about two-thirds of the people could not afford the user fee payments for health care services. It was also confirmed that, affordability of user fee payments varied greatly with respect to age, gender and occupation of respondents. Furthermore, the study found that, there was a poor design of user fee exemption scheme that led to strong undermining of the poor population. The study recommends that, there should be a need to build capacity of retaining fees locally thereby improving the incentive to collect and use the revenue for improving the quality of health care within the community. Moreover, the study recommends that, pricing of the health commodities must reflect the needs of the poor so that their general living standard is not compromised. Furthermore, there is a need to improve the design of user fee exemption scheme thereby improving the information with which to target the poorest through exemption.
Available in print form, East Africana Collection, Dr. Wilbert Chagula Library, Class mark ()
payments, health care, Misungwi
Nyanda, O (2015) An assessment of the significance of user fee payments for health care utilization in Tanzania a case of Misungwi district, Tanzania. Master dissertation, University of Dar es Salaam. Dar es Salaam.