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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Impact of user fees on attendance at a referral centre for sexually transmitted diseases in Kenya
The Lancet, Volume 340, No. 8817, Year 1992
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Description
We investigated the impact of a short-lived policy of charging fees to patients attending public-sector outpatient health facilities in Kenya by collecting data on attendance at Nairobi's Special Treatment Clinic for sexually transmitted diseases (STDs) before (23 months), during (9 months), and after (15 months) the user-charge period. During the user-charge period, the seasonally adjusted total mean monthly attendance of men decreased significantly to 40% (95% Cl 36-45) of that before fees were levied. Attendance rose in the post-user-charge period, but reached only 64% (59-68) of the pre-user-charge level. For women, the adjusted total mean monthly attendance during the user-charge period was reduced significantly to 65% (55-77) of the pre-user-charge level. Mean monthly attendance by women rose in the post-user-charge period to 22% (9-37) above the pre-user-charge level. There was no evidence of an increase in attendance over the course of the user-charge period among either men or women. The introduction of user fees probably increased the number of untreated STDs in the population, with potentially serious long-term health implications. The user-fee experience in Kenya should be carefully evaluated before similar measures are introduced elsewhere. © 1992.
Authors & Co-Authors
Moses, Stephen
Kenya, Nairobi
University of Nairobi
Plummer, Francis Allan
Kenya, Nairobi
University of Nairobi
Moses, S.
Canada, Winnipeg
Departments of Community Health Sciences
Plummer, Francis A.
Canada, Winnipeg
Departments of Community Health Sciences
Manji, Firoze
Kenya, Nairobi
International Development Research Centre
Bradley, Janet E.
Kenya, Nairobi
International Projects Assistance Services
Nagelkerke, Nico J.D.
Netherlands, Den Haag
International Statistical Institute
Malisa, M. A.
Kenya, Nairobi
Nairobi City Council
Statistics
Citations: 156
Authors: 8
Affiliations: 6
Identifiers
Doi:
10.1016/0140-6736(92)91778-7
ISSN:
01406736
Research Areas
Health System And Policy
Study Design
Cross Sectional Study
Study Locations
Kenya
Participants Gender
Male
Female