Perceptions towards the role of exemption scheme in utilization of health services among most vulnerable children in Tanga

Abstract

Background Tanzania is experiencing rapid increase in number of Most Vulnerable Children (MVC). Currently the total number of most vulnerable children is 10% of all child population. These children are facing serious challenges in utilizing health care due to various reasons including poverty, distance to health facility and ability to pay for health care. Health is an expensive commodity which MVC households fails to foot its costs. Given the existence of health exemption scheme for MVCs, why does utilization remain low was the fundamental question of this study. Materials and Methods The study aimed at exploring peoples’ perceptions on the role of exemption scheme in utilization of health services among most vulnerable children. A qualitative study was conducted in Tanga City Council. Using a purposive sampling technique, a tota of 36 key informants were recruited for participation in in-depth interviews. Thematic analysis was followed. Results The study revealed that, majority of the people perceived a poor coordination in the operationalization of health exemption scheme. It was further found that, the scheme covered only one MVC per MVC household. The scheme package of services was selective to cover less costly diseases only. Also the issue of running out of stock of drugs, entailed poor quality of health care was perceived as a challenge in utilization of health care. However, majority of the people perceived a scheme as a useful intervention that would meant a lot if it would cover all health services at the point of need. Conclusions and recommendations It is recommended that, key stakeholders for this intervention should be sensitized on exemption scheme implementation protocol. In addition, the health benefit package must be comprehensive to accommodate all health needs of MVCs. Finally, Tanga City Council vii should take necessary budgetary steps to avail medical supplies in all health facilities, giving special attention to MVCs who have been financially constrained to foot medical costs in health facilities, short of which morbidity and mortality rates among MVCs may increases due to resortment to folk healers, spiritual leaders and self medication.