Community health insurance amidst abolition of user fees in Uganda: the view from policy makers and health service managers.
Community health insurance amidst abolition of user fees in Uganda: the view from policy makers and health service managers.
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DOI：
10.1186/1472-6963-10-33
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发表时间：
2010-02-04
影响因子：
2.8
通讯作者：
Van der Stuyft P
中科院分区：
文献类型：
--
作者：
Basaza RK;Criel B;Van der Stuyft P
本文调查了乌干达主要政策制定者和卫生服务管理者对社区健康保险 (CHI) 的了解及其相关性的看法。社区健康保险计划目前在私人非营利部门、教堂设施运作的环境中运作。它们在更广泛的政策环境中运作，公共部门的使用费已被取消。 2007 年下半年，我们对地区卫生官员 (DHO) 和卫生部 (MOH) 的高级工作人员进行了半结构化访谈。使用 EZ-Text 软件辅助的框架方法对收集的定性数据进行分析。卫生部总部和 DHO 的工作人员对 CHI 活动知之甚少。然而，对答复的比较表明，与卫生部工作人员相比，DHO 中对 CHI 原则的认识水平相对较高。与没有计划的地区的 DHO 相比，有计划的地区的所有 DHO 都对 CHI 原则有了很好的理解。尽管政府机构全面取消了使用费，但自付费用仍然是乌干达医疗保健融资的一个重要特征。 CHI 被认为是医疗保健的相关政策选择和潜在资金来源。它也被认为是提高公立和私立卫生单位医疗保健质量的一种手段。为了评估在公共部门引入 CHI 是否可行，迫切需要调查利益相关者，特别是高层政治当局，是否愿意和准备好走这条新道路。目前乌干达卫生部卫生筹资政策中的模糊性和矛盾性需要解决和澄清。
This paper investigates knowledge of Community Health Insurance (CHI) and the perception of its relevance by key policy makers and health service managers in Uganda. Community Health Insurance schemes currently operate in the private-not-for-profit sector, in settings where church-based facilities function. They operate in a wider policy environment where user fees in the public sector have been abolished. Semi-structured interviews were conducted during the second half of 2007 with District Health Officers (DHOs) and senior staff of the Ministry of Health (MOH). The qualitative data collected were analyzed using the framework method, facilitated by EZ-Text software. There is poor knowledge and understanding of CHI activities by staff of the MOH headquarters and DHOs. However, a comparison of responses reveals a relatively high level of awareness of CHI principles among DHOs compared to that of MOH staff. All the DHOs in the districts with schemes had a good understanding of CHI principles compared to DHOs in districts without schemes. Out-of-pocket expenditure remains an important feature of health care financing in Uganda despite blanket abolition of user fees in government facilities. CHI is perceived as a relevant policy option and potential source of funds for health care. It is also considered a means of raising the quality of health care in both public and private health units. To assess whether it is also feasible to introduce CHI in the public sector, there is an urgent need to investigate the willingness and readiness of stakeholders, in particular high level political authorities, to follow this new path. The current ambiguity and contradictions in the health financing policy of the Uganda MOH need to be addressed and clarified.
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影响因子：
5.4
作者：
Atim, C
通讯作者：
Atim, C
影响因子：
3.3
作者：
Gilson, L;Kalyalya, D;Ouendo, M
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影响因子：
5.4
作者：
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通讯作者：
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影响因子：
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通讯作者：
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影响因子：
3.3
作者：
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通讯作者：
Van der Stuyft, Patrick