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.
