Impact of user fees on attendance at a referral centre for sexually transmitted diseases in Kenya
Identifieur interne : 004F95 ( Istex/Checkpoint ); précédent : 004F94; suivant : 004F96Impact of user fees on attendance at a referral centre for sexually transmitted diseases in Kenya
Auteurs : S. Moses [Kenya] ; F. A Plummer [Kenya] ; S. Moses [Canada] ; F. A Plummer [Canada] ; F. Manji [Kenya] ; J. E Bradley [Kenya] ; N. J. D Nagelkerke [Pays-Bas] ; M. A Malisa [Kenya]Source :
- The Lancet [ 0140-6736 ] ; 1992.
Descripteurs français
- Wicri :
- geographic : Kenya.
- topic : Soins de santé, Entreprise privée.
English descriptors
- KwdEn :
- Attendance, Centre, Chancroid, Common diagnoses, Community health, Essential health services, Genital herpes, Gonorrhoea, Health care, Health centres, Health planning management, Health policy planning, Health services, Human immunodeficiency virus type, Initial visit, Kenya, Medical microbiology, Monthly attendance, Monthly income, Nairobi, Nairobi city commission, Outpatient health facilities, Primary level, Private sector, Referral centre, Same level, Special treatment clinic, Std, Syphilis, Untreated stds, User, User charges, User fees, World bank.
- Teeft :
- Attendance, Centre, Chancroid, Common diagnoses, Community health, Essential health services, Genital herpes, Gonorrhoea, Health care, Health centres, Health planning management, Health policy planning, Health services, Human immunodeficiency virus type, Initial visit, Kenya, Medical microbiology, Monthly attendance, Monthly income, Nairobi, Nairobi city commission, Outpatient health facilities, Primary level, Private sector, Referral centre, Same level, Special treatment clinic, Std, Syphilis, Untreated stds, User, User charges, User fees, World bank.
Abstract
Abstract: 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.
Url:
DOI: 10.1016/0140-6736(92)91778-7
Affiliations:
Links toward previous steps (curation, corpus...)
Links to Exploration step
ISTEX:DF4DCA1AF08675651360A04DA148803923FA1C86Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Impact of user fees on attendance at a referral centre for sexually transmitted diseases in Kenya</title>
<author><name sortKey="Moses, S" sort="Moses, S" uniqKey="Moses S" first="S" last="Moses">S. Moses</name>
</author>
<author><name sortKey="Plummer, F A" sort="Plummer, F A" uniqKey="Plummer F" first="F. A" last="Plummer">F. A Plummer</name>
</author>
<author><name sortKey="Moses, S" sort="Moses, S" uniqKey="Moses S" first="S" last="Moses">S. Moses</name>
</author>
<author><name sortKey="Plummer, F A" sort="Plummer, F A" uniqKey="Plummer F" first="F. A" last="Plummer">F. A Plummer</name>
</author>
<author><name sortKey="Manji, F" sort="Manji, F" uniqKey="Manji F" first="F" last="Manji">F. Manji</name>
</author>
<author><name sortKey="Bradley, J E" sort="Bradley, J E" uniqKey="Bradley J" first="J. E" last="Bradley">J. E Bradley</name>
</author>
<author><name sortKey="Nagelkerke, N J D" sort="Nagelkerke, N J D" uniqKey="Nagelkerke N" first="N. J. D" last="Nagelkerke">N. J. D Nagelkerke</name>
</author>
<author><name sortKey="Malisa, M A" sort="Malisa, M A" uniqKey="Malisa M" first="M. A" last="Malisa">M. A Malisa</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">ISTEX</idno>
<idno type="RBID">ISTEX:DF4DCA1AF08675651360A04DA148803923FA1C86</idno>
<date when="1992" year="1992">1992</date>
<idno type="doi">10.1016/0140-6736(92)91778-7</idno>
<idno type="url">https://api.istex.fr/document/DF4DCA1AF08675651360A04DA148803923FA1C86/fulltext/pdf</idno>
<idno type="wicri:Area/Istex/Corpus">004885</idno>
<idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">004885</idno>
<idno type="wicri:Area/Istex/Curation">004885</idno>
<idno type="wicri:Area/Istex/Checkpoint">004F95</idno>
<idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Checkpoint">004F95</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title level="a">Impact of user fees on attendance at a referral centre for sexually transmitted diseases in Kenya</title>
<author><name sortKey="Moses, S" sort="Moses, S" uniqKey="Moses S" first="S" last="Moses">S. Moses</name>
<affiliation wicri:level="1"><country xml:lang="fr">Kenya</country>
<wicri:regionArea>Departments of Community Health and Medical Microbiology, University of Nairobi, Nairobi</wicri:regionArea>
<wicri:noRegion>Nairobi</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Plummer, F A" sort="Plummer, F A" uniqKey="Plummer F" first="F. A" last="Plummer">F. A Plummer</name>
<affiliation wicri:level="1"><country xml:lang="fr">Kenya</country>
<wicri:regionArea>Departments of Community Health and Medical Microbiology, University of Nairobi, Nairobi</wicri:regionArea>
<wicri:noRegion>Nairobi</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Moses, S" sort="Moses, S" uniqKey="Moses S" first="S" last="Moses">S. Moses</name>
<affiliation wicri:level="4"><country xml:lang="fr">Canada</country>
<wicri:regionArea>Departments of Community Health Sciences, Medical Microbiology, and Medicine, University of Manitoba, Winnipeg</wicri:regionArea>
<orgName type="university">Université du Manitoba</orgName>
<placeName><settlement type="city">Winnipeg</settlement>
<region type="state">Manitoba</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Plummer, F A" sort="Plummer, F A" uniqKey="Plummer F" first="F. A" last="Plummer">F. A Plummer</name>
<affiliation wicri:level="4"><country xml:lang="fr">Canada</country>
<wicri:regionArea>Departments of Community Health Sciences, Medical Microbiology, and Medicine, University of Manitoba, Winnipeg</wicri:regionArea>
<orgName type="university">Université du Manitoba</orgName>
<placeName><settlement type="city">Winnipeg</settlement>
<region type="state">Manitoba</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Manji, F" sort="Manji, F" uniqKey="Manji F" first="F" last="Manji">F. Manji</name>
<affiliation wicri:level="1"><country xml:lang="fr">Kenya</country>
<wicri:regionArea>Health Sciences Division, Regional Office for Eastern and Southern Africa, International Development Research Centre, Nairobi</wicri:regionArea>
<wicri:noRegion>Nairobi</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bradley, J E" sort="Bradley, J E" uniqKey="Bradley J" first="J. E" last="Bradley">J. E Bradley</name>
<affiliation wicri:level="1"><country xml:lang="fr">Kenya</country>
<wicri:regionArea>International Projects Assistance Services, Nairobi</wicri:regionArea>
<wicri:noRegion>Nairobi</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Nagelkerke, N J D" sort="Nagelkerke, N J D" uniqKey="Nagelkerke N" first="N. J. D" last="Nagelkerke">N. J. D Nagelkerke</name>
<affiliation wicri:level="1"><country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>International Statistical Institute, The Hague</wicri:regionArea>
<wicri:noRegion>The Hague</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Malisa, M A" sort="Malisa, M A" uniqKey="Malisa M" first="M. A" last="Malisa">M. A Malisa</name>
<affiliation wicri:level="1"><country xml:lang="fr">Kenya</country>
<wicri:regionArea>Special Treatment Clinic, Nairobi City Commission, Nairobi</wicri:regionArea>
<wicri:noRegion>Nairobi</wicri:noRegion>
</affiliation>
</author>
</analytic>
<monogr></monogr>
<series><title level="j">The Lancet</title>
<title level="j" type="abbrev">LANCET</title>
<idno type="ISSN">0140-6736</idno>
<imprint><publisher>ELSEVIER</publisher>
<date type="published" when="1992">1992</date>
<biblScope unit="volume">340</biblScope>
<biblScope unit="issue">8817</biblScope>
<biblScope unit="page" from="463">463</biblScope>
<biblScope unit="page" to="466">466</biblScope>
</imprint>
<idno type="ISSN">0140-6736</idno>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><idno type="ISSN">0140-6736</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Attendance</term>
<term>Centre</term>
<term>Chancroid</term>
<term>Common diagnoses</term>
<term>Community health</term>
<term>Essential health services</term>
<term>Genital herpes</term>
<term>Gonorrhoea</term>
<term>Health care</term>
<term>Health centres</term>
<term>Health planning management</term>
<term>Health policy planning</term>
<term>Health services</term>
<term>Human immunodeficiency virus type</term>
<term>Initial visit</term>
<term>Kenya</term>
<term>Medical microbiology</term>
<term>Monthly attendance</term>
<term>Monthly income</term>
<term>Nairobi</term>
<term>Nairobi city commission</term>
<term>Outpatient health facilities</term>
<term>Primary level</term>
<term>Private sector</term>
<term>Referral centre</term>
<term>Same level</term>
<term>Special treatment clinic</term>
<term>Std</term>
<term>Syphilis</term>
<term>Untreated stds</term>
<term>User</term>
<term>User charges</term>
<term>User fees</term>
<term>World bank</term>
</keywords>
<keywords scheme="Teeft" xml:lang="en"><term>Attendance</term>
<term>Centre</term>
<term>Chancroid</term>
<term>Common diagnoses</term>
<term>Community health</term>
<term>Essential health services</term>
<term>Genital herpes</term>
<term>Gonorrhoea</term>
<term>Health care</term>
<term>Health centres</term>
<term>Health planning management</term>
<term>Health policy planning</term>
<term>Health services</term>
<term>Human immunodeficiency virus type</term>
<term>Initial visit</term>
<term>Kenya</term>
<term>Medical microbiology</term>
<term>Monthly attendance</term>
<term>Monthly income</term>
<term>Nairobi</term>
<term>Nairobi city commission</term>
<term>Outpatient health facilities</term>
<term>Primary level</term>
<term>Private sector</term>
<term>Referral centre</term>
<term>Same level</term>
<term>Special treatment clinic</term>
<term>Std</term>
<term>Syphilis</term>
<term>Untreated stds</term>
<term>User</term>
<term>User charges</term>
<term>User fees</term>
<term>World bank</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Kenya</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Soins de santé</term>
<term>Entreprise privée</term>
</keywords>
</textClass>
<langUsage><language ident="en">en</language>
</langUsage>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Abstract: 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.</div>
</front>
</TEI>
<affiliations><list><country><li>Canada</li>
<li>Kenya</li>
<li>Pays-Bas</li>
</country>
<region><li>Manitoba</li>
</region>
<settlement><li>Winnipeg</li>
</settlement>
<orgName><li>Université du Manitoba</li>
</orgName>
</list>
<tree><country name="Kenya"><noRegion><name sortKey="Moses, S" sort="Moses, S" uniqKey="Moses S" first="S" last="Moses">S. Moses</name>
</noRegion>
<name sortKey="Bradley, J E" sort="Bradley, J E" uniqKey="Bradley J" first="J. E" last="Bradley">J. E Bradley</name>
<name sortKey="Malisa, M A" sort="Malisa, M A" uniqKey="Malisa M" first="M. A" last="Malisa">M. A Malisa</name>
<name sortKey="Manji, F" sort="Manji, F" uniqKey="Manji F" first="F" last="Manji">F. Manji</name>
<name sortKey="Plummer, F A" sort="Plummer, F A" uniqKey="Plummer F" first="F. A" last="Plummer">F. A Plummer</name>
</country>
<country name="Canada"><region name="Manitoba"><name sortKey="Moses, S" sort="Moses, S" uniqKey="Moses S" first="S" last="Moses">S. Moses</name>
</region>
<name sortKey="Plummer, F A" sort="Plummer, F A" uniqKey="Plummer F" first="F. A" last="Plummer">F. A Plummer</name>
</country>
<country name="Pays-Bas"><noRegion><name sortKey="Nagelkerke, N J D" sort="Nagelkerke, N J D" uniqKey="Nagelkerke N" first="N. J. D" last="Nagelkerke">N. J. D Nagelkerke</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/SidaSubSaharaV1/Data/Istex/Checkpoint
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 004F95 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Checkpoint/biblio.hfd -nk 004F95 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Sante |area= SidaSubSaharaV1 |flux= Istex |étape= Checkpoint |type= RBID |clé= ISTEX:DF4DCA1AF08675651360A04DA148803923FA1C86 |texte= Impact of user fees on attendance at a referral centre for sexually transmitted diseases in Kenya }}
![]() | This area was generated with Dilib version V0.6.32. | ![]() |