Assessment of the free health care provision system In Northern Ethiopia
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Date
1999-12
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Addis Abeba Universty
Abstract
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 characteristics 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 administrators 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 institutions. 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 wi ll help to have better understanding of the issues regarding the proper
implementation of waiver and exemption mechanisms.
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Assessment of the free health care provision system