Assessment of fee waiver health care implementation status in the new health care financing strategy in Bahir Dar, North West Ethiopia

Abstract

Problem statement: Many governments in Africa tried alternative arrangements for paying, allocating, organizing and managing health resources. The strategy includes measures to ensure the benefit of poorest people. The success of targeting the poor depends on the quality of implementation. Objectives: To describe the implementation status of fee waiver health care in the new health care financing strategy and assess the satisfaction of beneficiaries in Bahir Dar city, North West Ethiopia. Methods: A qualitative study was conducted involving fee waiver implementing organizations and beneficiaries for health care in Bahir Dar. The study was conducted from August – November 2010. The data were collected using in- depth interviews and observations. The data were analyzed using modified grounded theory approach with the help of the open code 3.4 computer program. Result: In the new health care and financing strategy, there is an established system for implementing fee waiver health care for those who can not pay by themselves. The new fee waiver system has been implemented since 2007 having its own guidelines. But some of the Implementers some times deviate from the guideline as they thought it was not detailed and comprehensive. Awareness creation on the opportunity and procedures of the new system was not done. Beneficiaries are satisfied with the service procedure, but the shortage of drugs for free makes their benefit uncertain. Conclusion: poor awareness on the new system denied the opportunity of potential beneficiaries. Updating the status of beneficiaries’ to recruit new and drop the existing based on their current status was not done so far. Implementers had strong desire to review guideline as it assisted them to identify beneficiaries objectively. Recommendation: Implementers should aware potential beneficiaries and the community at large on the new system. The guideline shall be reviewed in the presence of implementers. Dropping the rehabilitated beneficiaries and adding new for the service should be done on regular bases.