Users' experience of primary healthcare services after the removal of user fees: A study of Chelstone and Mtendere Townships(2012-2014)

Abstract

The study sought to investigate the users’ experiences of primary healthcare services after the removal of user fees in the urban townships of Mtendere and Chelstone. This is because after the removal of user fees, the experiences of users of primary healthcare services do not seem to be systematically documented. Specific objectives were to: i) Determine whether, after the removal of user fees, users encountered any fees at primary health care centers; ii) Establish the time spent by users at health facilities at primary healthcare centre’s; and iii) Examine the extent to which users had access to prescribed drugs at the primary health care centers. The study used exploratory and descriptive survey designs. It collected both qualitative and quantitative data. The study used a sample size of 260 respondents broken down as follows: 130 residents each from Mtendere and Chelstone townships. The study used a two-stage stratified cluster sample design. Twelve (12) health workers, as key informants, were selected using purposive sampling, six (06) each from the health centers and two district community health officials. Quantitative data collected was analysed using computer generated software, while qualitative data was transcribed into major themes. The findings revealed that most of the respondents (93.9 percent) were charged for registration. 95.4 percent of the users said they were not charged for consultation. On the average, respondents spent about 2 hours waiting to be attended to by a doctor or clinic officer at the Health Centre. The responses showed that respondents spent more than 48 minutes above the time that users spent before the removal of user fees. Further, the responses revealed that respondents spent about 3 hours as the total time at the health centre. Most respondents (54.6 percent) did not find the drugs at the Health Centre’s pharmacy. Due to lack of drugs at health centres, respondents experienced drug cost at private chemists of about K43.8. Three quarters (74.2 percent) of the respondents said there was inadequate staff at the Health Centre they visited. The study recommended that: i) there is need to ensure there strict adherence to the no fee policy; (ii) There is need to build more health facilities to reduce on the long waiting times and; iii) Emphasis should be placed on ensuring that drug availability is increased since utilisation increased.