Perceptions of clients, local officials and health providers on charging user fees for selected health services in Malalag, Davao Del Sur

• Main Author: Lim, Maricel B.
• Format: text
• Language: English
• Published: Animo Repository 1998
• Subjects: Medical care > Cost of > Philippines; Public health; Social service > Philippines > Finance; Health service areas; User charges; Social and Behavioral Sciences
• Online Access: https://animorepository.dlsu.edu.ph/etd_masteral/1910
• Institution: De La Salle University

The study examines the perceptions of clients, health providers and local government officials regarding the charging of user fees for health services for preschool children in Malalag, Davao del Sur. The policy on user charges in Malalag was implemented in 1994 by virtue of the enactment of the Local Revenue Code of Malalag. Among other provisions, the Local Revenue Code provided for revenue enhancement programs of the municipal government.The study pointed out that the Malalag government's intention of charging user fees is to raise additional revenues to cover the cost of providing social services to the community. Its secondary aim is to develop self-reliance among the people and to increase their participation in the concerns of local governance. Since the implementation of user fees in 1994, all health services including laboratory tests, immunization, prenatal, natal, and postnatal care, and other similar services were already charged with fixed fees. The medicines at the health center were also sold at five-percent mark-up. The government of Malalag was able to defray about 12 percent of the expenditures for health services from the revenues raised through the imposition of user charges in 1996.The perception of clients regarding the user charges and its effect on health service utilization was obtained through a survey of 85 mothers of preschoolers in Malalag. The study findings pointed out that over 50 percent of the women were not supportive of the policy on user charges. Over 40 percent also said that they were not fully aware of the aims/purposes of the revenue-enhancing programs of the local government. The client's negative perceptions about user fees, however, have not prevented them from utilizing the services of the local health office, particularly for immunization services. About 94 percent of the respondents have utilized the immunization services of the health center and the BHS after the implementation of user fees. This can be attributed to their perceived affordability of the immunization services. In comparison, only about 48 percent of the respondents have utilized the curative services of the local health center. A majority of the respondents were also found to be using the services of both public and private medical practitioners, as well as that of traditional healers. The low utlization rate of curative services appeared to be related to 1) the availability of the doctor at the health center 2) perceived tediousness in getting referrals from the midwives before the client can proceed to the main health center 3) the perceived tediousness of paying for the medicines, laboratory tests and other related services at the municipal treasurer's office and 4) the perception that the cost of medicines at the health center and private pharmacy is just the same.The Malalag experience in implementing a policy on user charges have been found to be successful although it was also challenged by a number of problems. Among these are the lack of information/understanding of the clients regarding user fees and the low demand for curative services.