title: Effects of new service charges on attendance at rural health facilities in Kenya.
abstract: Kenyans have long enjoyed free outpatient health care at government facilities while paying for admission and for child delivery. In December 1989 user charges were introduced also for out-patient care at hospitals and health centres. This before-and-after study of one rural hospital, two health centres and two dispensaries in rural Kenya shows major and statistically significant early drops in outpatient attendance at the hospital (28%) and at the health centres (50 and 43%) followed by a slow increase during the following months. There was a modest, not significant, decline also at the dispensaries (14 and 7%) and in demand for services unaffected by the new fees and charges.
authors.affiliation: African Medical and Research Institute (AMREF). Oxfam, Kampala, Uganda.
authors.forename: B
authors.initials: B
authors.lastname: Osuga
authors.forename: E
authors.initials: E
authors.lastname: Nordberg
mesh_terms: D003151:Community Health Centers / Q000191:economics* / Q000706:statistics & numerical data* / Q000639:trends; D017047:Cost Sharing; D005249:Fees and Charges; D006302:Health Services Research; D006801:Humans; D007630:Kenya; D010044:Outpatient Clinics, Hospital / Q000191:economics* / Q000706:statistics & numerical data* / Q000639:trends; D010594:Pharmacies / Q000191:economics* / Q000706:statistics & numerical data*; D012423:Rural Health