Assessing performance of the exemption scheme.

Abstract

Despite the existence of the national exemptions policy in Tanzania a large proportion of the deserving poor and vulnerable in the country do not have adequate access to health care. A conspicuous group among these is cancer patients who need lifelong treatment and expensive drugs. This was the basis of study to assess the extent of implementation and utilization of Exemption scheme at Ocean Road Cancer institute. To assess the performance of the exemption scheme for the purpose of improving lives of the people suffering from cancer at ORCI through addressing identified gaps. This was a cross sectional study employing both qualitative and quantitative approaches. The quantitative approach involved about 210 patients selected by systematic sampling whereby responses were obtained by administering structured questionnaire, and the qualitative approach involved purposively selected 6 key informants whereby in-depth interview was used to obtain attitudes, views, and experiences in regards to exemption implementation A total of 210 patients and 6 key informants participated in the study. The study found only 41% received complete (full) exemption for chemotherapy, while for laboratory and X-ray services were 24.8% and 33% respectively. Awareness amongst patients and workers was relatively high and the main source of information being health workers by 61%. On resources availability the study found that anticancer medicines and diagnostic machines are not in constant supply of services for long time leading to low exemption of the services. Despite the government‟s policy on exempting treatment services for cancer patients still the coverage is low. The Government through MOHSW to increase budget allocation in regard to the growing cancer health problem, advocate for universal coverage through social health security schemes which would dispense some percent of their earning to the need of exemption and provision of special Insurance Cards for cancer patients to assist in exempting them during transportation. The ORCI to timely repair the broken machines so that the services are readily available and possible provision of back- up machines necessary for diagnostic purposes