User fees and drugs: what did the health reforms in Zambia achieve?
The article reports on exploratory research into the effects and prospects of health reforms in Zambia. The research, which was qualitative, was carried out in two rural and two urban health centres and their surrounding catchment populations. The authors focus on four principles of health reform: community involvement (including cost sharing), prevention, equity and quality of care. One of their main conclusions is that many people criticize the introduction of cost sharing because it does not improve the quality of care, by which they first of all mean the availability of drugs. The authors plead for a humane implementation of user fees in public health care that is directly linked to a more efficient provision of essential medicines.
van der Geest
S
S
Anthropological-Sociological Centre, University of Amsterdam, The Netherlands.vandergeest@pscw.uva.nl
Macwan'gi
M
M
Kamwanga
J
J
Mulikelela
D
D
Mazimba
A
A
Mwangelwa
M
M
D003256:Community Participation; D017047:Cost Sharing; D017048:Health Care Costs; D018166:Health Care Reform; D007348:Insurance, Health; D011314:Preventive Health Services; D011787:Quality of Health Care; D012107:Research Design; D015024:Zambia