Ahmed A M, Urassa D P, Gherardi E, Game N Y
International Course for Health Managers (ICHM), Istituto Superiore di Sanita, Rome, Italy.
East Afr Med J. 1996 Jun;73(6):370-4.
Eighty percent of rural dispensaries are run by the government and 19% by voluntary organisations that charge for some services. After the re-legalisation of the private health sector in 1991, private dispensaries are also emerging in villages. Privatisation is among the health reform policies of the country. Moreover, cost-sharing will be introduced at public dispensaries soon. Perception of 320 patients in the Coast Region of Tanzania on services delivered by the three health sectors has been investigated. Results show that patients are generally satisfied with the services and they would go back to the same dispensaries for treatment. Polydrug prescription was common in all sectors, while lack of prescribed drugs was a main complaint among public dispensaries patients. Voluntary dispensaries patients were less satisfied with long waiting time and with staff that did not give them enough information about the treatment. Currently, health service in public dispensaries is free but cost-sharing will be introduced soon. Most of voluntary and private dispensaries patients stated that the fees for service were moderate. The paper discusses the need for monitoring the implementation of cost sharing in public dispensaries to ensure equity in access to services by rural patients.
80%的农村诊疗所由政府运营，19%由一些服务收费的志愿组织运营。1991年私营医疗部门重新合法化后，乡村地区也出现了私人诊疗所。私有化是该国医疗改革政策之一。此外，不久后公共诊疗所将推行费用分担制度。对坦桑尼亚沿海地区320名患者对三个医疗部门提供的服务的看法进行了调查。结果显示，患者总体上对服务感到满意，并且会回到同一家诊疗所接受治疗。多药处方在所有部门都很常见，而药品短缺是公共诊疗所患者的主要抱怨。志愿诊疗所的患者对等待时间过长以及工作人员未充分提供治疗信息不太满意。目前，公共诊疗所的医疗服务是免费的，但不久后将推行费用分担制度。大多数志愿诊疗所和私人诊疗所的患者表示服务收费适中。本文讨论了监测公共诊疗所费用分担制度实施情况的必要性，以确保农村患者获得服务的公平性。
