Cost of access to health services in Zambia

Abstract

Equity is an important policy objective in the health care field. The importance of equity in health care provision can be argued from various points of view. As a result governments in all countries attempt to provide health care systems that enable equal access for everyone. Zambia is no exception. In the health care reforms the objective of the national health strategy is to provide Zambians with equity of access to health care. We focus on access defined as the costs (both monetary and time) an individual incurs when visiting a health care facility. Using a survey of 900 households, this article explores equality of access to health care among Zambians. Four areas are compared: urban high cost, urban low cost, townships and rural areas. The results of the analysis indicate that there are inequalities among residential areas, especially between rural and urban areas. In particular these differences exist because of differing distances to the nearest health facility. Large distances make it very costly for rural dwellers to seek medical care, especially during the high season for farming. The analysis suggests that obtaining equality of access to health care poses a challenge for the Zambian Government.

Rural–urban differences in health-seeking for the treatment of childhood malaria in south-east Nigeria

“…The rural dwellers, who already live in resource poor environment and are mostly subsistence farmers, pay twice the amount the urban dwellers pay as transport cost while seeking health for their children suffering from malaria. In developing countries where distances to health facilities can be large, the infrastructure lacking and a large share of the population live below the poverty line, cost of access is a critical determinant of whether care is sought or not [41].…”

Impact of cost and perceived quality on utilisation of primary health care services in Tanzania: rural-urban comparison

“…It can be deduced from this observation that if cost is a barrier to primary health care use, one direct effect is that the cost effectiveness of interventions will be reduced and the costs of malaria intervention will in the long run increase. According to Hjortsberg and Mwikisa (2002), reduced effectiveness of health care interventions is attributed to among other things, existing barriers that prevent consumers from using health care.…”

“…According to Hjortsberg and Mwikisa (2002), cost of access creates an especially problematic barrier to the poor people who need to seek care. It is further argued that in developing countries where distances to health facilities can be large, the infrastructures lacking and large number of people living below the poverty line, cost of access is a critical determinant of whether care is sought or not.…”

Untitled

“…With respect to UHC in Zambia, the major obstacle reported were long distances to health facilities especially during the rain farming seasons (Hjortsberg et al, 2002). In public health facilities it was reported that the rich had better access to the hospitals and the poor used primary health care facilities.…”

“…There has been a disparity between the scope and quality between rural and urban services with the latter getting better services (Hjortsberg et al, 2002). The PHC approach has remarkably improved health services in some areas but not to level of attaining universal health coverage (UHC) (Yach, 1997).…”