Assessment of the Free Health Care Provision System in Northern Ethiopia

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Addis Ababa University


Exemptions from user charges have proven to be very hard to implement in those countries that have adopted them . Poor screening mechanisms have been the main reason for the difficulty of identifying those patients who are able to pay for granting free care services from those that don't have the ability. This is a result of a cross sectional descriptive study that compared the chara cteristics of free patients with those paying at the analysis stage in the northern part of Ethiopia. In addition, it has assessed the presence and extent of under coverage and leakage in the provision of free health services. The study utilized a multistage sampling method for the household survey and systematic random sampling for exit interview. In addition, kebele free treatment letter writers, and health institution administra tors were purposively selected to fulfil the study objectives. According to the results of the study, provision of free health care represented for more than half (52.4%) of government health expenditure in the area. Even though the problem of under coverage and leakage was not very high, there was no statistical significant association between low income and getting free care in rural public health institution s. Proper registration of free treatment provision seemed to be the most important mechanism for the system to function efficiently. Even though most health institutions have registration books for recording free treatment, they were not properly using them. As Ethiopia is one of the countries that attempts to ensure access to health care by the poor, the results of this study will help to have better understanding of the issues regarding the proper implementation of waiver and exemption mechanisms.