User fees impact access to healthcare for female children in rural Zambia

Costantine Malama, Qin Chen, Roberto De Vogli, Gretchen L. Birbeck

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

The World Bank and International Monetary Fund favor healthcare user fees. User fees offer revenue and may decrease inappropriate care. However, user fees may deter needed care, especially in vulnerable populations. A cross-sectional analysis of healthcare utilization in a large Zambian hospital was conducted for children 3-6 years of age during a 1-month observation period. Diagnoses and treatments were compared using paired t-tests. Chi-squared tests compared outpatient service use. The relative risk of admission was determined for each stratum. Logistic models were developed to evaluate the impact of age, gender, and the age-gender interaction on hospital admissions. Trends suggest female children may be less likely to present for care when user fees are imposed. However, treatment type, treatment number, and number of diagnoses did not differ between genders. The relative risk of admission was highest for males 5-6 years old. Neither age nor gender alone was a significant determinant of hospital admission. However, the age-gender interaction was significant with female admissions least likely when costs were incurred. We conclude that user fees appear to decrease differentially utilization of inpatient care for female children in rural Zambia.

Original languageEnglish (US)
Pages (from-to)371-372
Number of pages2
JournalJournal of Tropical Pediatrics
Volume48
Issue number6
DOIs
StatePublished - Dec 2002

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Zambia
Fees and Charges
Delivery of Health Care
United Nations
Vulnerable Populations
Ambulatory Care
Child Care
Inpatients
Therapeutics
Cross-Sectional Studies
Logistic Models
Observation
Costs and Cost Analysis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Immunology

Cite this

User fees impact access to healthcare for female children in rural Zambia. / Malama, Costantine; Chen, Qin; De Vogli, Roberto; Birbeck, Gretchen L.

In: Journal of Tropical Pediatrics, Vol. 48, No. 6, 12.2002, p. 371-372.

Research output: Contribution to journalArticle

Malama, Costantine ; Chen, Qin ; De Vogli, Roberto ; Birbeck, Gretchen L. / User fees impact access to healthcare for female children in rural Zambia. In: Journal of Tropical Pediatrics. 2002 ; Vol. 48, No. 6. pp. 371-372.
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