Impacts of free primary health services in Mpika district for the last 10 years.

Abstract

This study sought to determine the impact of free primary health care in Mpika district for the last 10 years that Zambia as a nation has provided free health services. Its target respondents were the health sector staff and the clients (patients). Its objectives were to determine the impact of free health care on utilization of the health facilities by means of responses obtained from patients at the facilities. It also investigated the meaning of quality of health care among the clients and sought to determine if, in the opinion of the clients, the removal of User Fees improved the quality of health care in the district. The last specific objective of this study was to determine the effects on health system management brought about by free health services. The research selected health centres in the district from which in-charges were interviewed. Clients were also interviewed along with conveniently selected long serving employees and health system administrators. Interview guides and data extraction tools were used as data collection tools. The study’s main findings where that utilization of health centres increased and that the client’s perspective of the impact on quality of health care was that it improved upon revocation of User Fees. The health system lost a source of income, accountability to the community was reduced and there was a reduction in the amounts of unaccounted for finances. Another thing that resulted from the removal of User Fees was the reduction in the perceived value of health care and medical supplies by the community. The study recommends that other options of financing, especially those that pool up resources and don’t demand direct cost from the clients on access of health care should be adopted to ease the financial burden on individual patients. It also recommends that resources should be channeled to reducing patient waiting time, cleaning the environment and availing drugs for use as these are the elements that constitute quality health care in Mpika district from the clients’ perspective. The community should be deliberately involved in the process of delivering health care and that financial regulations should be applied to all financing options so as to increase the level of accountability and reduce the amount of unaccounted for resources. For further research, this study recommends that future researchers focus on determination of the extent of the increase of health facility utilization that resulted from the revocation of the User Fees in the district. This would help the health financers to determine what health financing levels will optimize health care while maintaining a reasonable health facility utilization rate.