Osuga B, Nordberg E
African Medical and Research Institute (AMREF). Oxfam, Kampala, Uganda.
East Afr Med J. 1993 Oct;70(10):627-31.
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.
长期以来，肯尼亚人在政府医疗机构享受免费门诊医疗服务，但住院和分娩需付费。1989年12月，医院和健康中心的门诊服务也开始收取费用。这项针对肯尼亚农村地区一家乡村医院、两个健康中心和两个诊疗所的前后对比研究表明，医院门诊量（下降28%）和健康中心门诊量（分别下降50%和43%）在政策实施初期出现了大幅且具有统计学意义的下降，随后几个月缓慢回升。诊疗所门诊量也出现了适度下降（分别下降14%和7%），但未达到显著水平，且不受新收费政策影响的服务需求也有所下降。
