Effects of user fees on the utilization pattern of family planning services in primary care centers in St. Elizabeth

Effective family planning services are critical to reducing fertility levels and increasing life expectancy. With declining donor support and the inability of public health resources to provide for all, the introduction of user fees - a cost recovery alternative was adopted. The study was conducted on 250 women 15-39 years in St. Elizabeth. The results indicate that although 49 percent women discontinued the use of contraceptives after the introduction of user fees, a similar proportion accepted a contraceptive method. More women, however, chose low cost contraceptives. Women are willing to pay for contraceptives based on their economic status; but concern exists for the under privileged who are unable to pay for a service which is so vital to the entire population. The need exists for strategies to be employed in the assessment of women, so that the poor can access these services free of cost, and for improving cost effective use of resources. The study points to the need for structured, ongoing family planning educational programmes focused on individual needs of both sexes. Formal education and employment opportunities could also play a major role in accessing family planning services. The search for alternate methods of financing such as private sector/community involvement, to supplement user fees, may be seen as another option (AU)

Comparative health care financing in St. Lucia, Grenada and Dominica

Presents the findings of a study of health care financing in the English-speaking Caribbean. The initial objective of the study was to explore whether increased support for maternal and child health might be provided through an expansion of social insurance coverage to include health benefits for workers and their dependents and also to find out how countries can adapt the organization, financing and delivery of health services so as to continue to provide primary health care equitably and efficiently, while at the same time providing essential secondary and tertiary level services. Details of the comparative study of the health systems in the three countries in terms of the adequacy of the health care provided at different levels and the real resources with which it is provided. Findings show that the level of health care spending both from public and private sources vary considerably among the islands. Includes statistical data on expenditure on health as well as the findings of a survey of consumers' view on the organization and quality of health care in the islands