Bibliography: leaves 49-51. / The lack of patient care and utilisation data impairs the ability of hospital and clinic administrators to make informed, data-driven policy choices. This concern is particularly acute with HIV/AIDS, given both the striking growth in the local epidemic over the last two years and the high level of HIV-related health expenditures shouldered by the provincial medical system in the Western Cape province of South Africa. A retrospective chart review was conducted to capture clinical and utilisation data of from a sample of 59 inpatients, who were admitted to a township secondary hospital near Cape Town, South Africa during 1997. Three years of data were abstracted and analysed.

Includes bibliographical references (leaves 121-127). / This study was aimed at examining the economic consequences and the coping mechanisms used by households affected by HIV/AIDS. There is concern that even with the provision of free Antiretroviral Therapy (ART); HIV/AIDS may exert negative economic consequences on People Living with HIV/AIDS (PLWHA) and their households. Households then come up with coping mechanisms in response to the economic burden of HIV/AIDS. In addition, social capital available to households may positively influence households' ability to cope with the economic burden of HIV/AIDS.

Bibliography: leaves 37-38. / Family planning services in South Africa are now provided by the provincial and local authorities through clinics, hospitals, day hospitals, and mobile clinics. Both service providers and recipients have identified a range of problems with the current family planning service delivery system. Community-based distribution of contraceptives (CBD) has become a generally accepted alternative to clinic-based programmes for the distribution of contraceptives in many developing countries. The piloting of community-based distribution of contraceptives project in Khayelitsha, Cape Town / South Africa, is being undertaken by The Planned Parenthood Association of South Africa (a non-governmental organization), in collaboration with two other NGOs who run preventive and promotive health projects, SACLA and Zibonele. The objective of this study was to perform a cost analysis of alternative methods for providing effective contraceptive services. Clinic-based services for contraceptives, day hospital-based contraceptive services, and community-based distribution (CBD) of contraceptives programmes were evaluated. The following items were costed: salaries, contraceptives, buildings, equipment, vehicle, transport, repairs & maintenance, utilities, initial training, short-in-service training, and consultancy.

Includes bibliographical references. / This study investigates the economic consequences of illness and of paying for health care in Zimbabwe. It explores the incidence of out-of-pocket (OOP) payments, catastrophic health expenditure (CHE), impoverishment and the factors, (particularly socio-economic factors) associated with them. In addition, this study determines the strategies that households employ to cope with the financial burden of OOP payments in Zimbabwe. Data was collected from 499 households in Harare urban and Seke rural districts of Zimbabwe. Total monthly household OOP health expenditure was defined as 'catastrophic' if it exceeded the threshold level of 40% of a household's monthly capacity to pay. Logistic regression analysis was used to identify the factors that influence the incidence of CHEs. A non-poor household was impoverished by OOP health expenditure if its total household expenditure after deducting OOP payments was lower than the subsistence expenditure. The results of this study indicated that, the incidence of CHEs was very high amongst the study population. Households at all levels of wealth incurred catastrophic health expenditures, and the proportion of households incurring CHEs was similar across the asset quintiles. Out-of-pocket payments precipitated impoverishment of non-poor households. Poor households, households with members above 65 years, female headed households, households with member(s) suffering from chronic illness and households with greater use of health services were at higher risk of incurring CHEs. On the contrary, households with a disabled member were less likely to incur CHEs. Besides 'avoiding seeking care', selling of assets and borrowing were the 2 most popular strategies used to cope with OOP health care payments. An analysis of these results suggests that, targeted exemption of vulnerable households, as well as provision of subsidised health services could reduce the economic impact of illness on households. The results of this study also point out to the need for strengthening risk pooling mechanisms through the implementation of community based health insurance schemes and enhancing tax collection. In addition, other strategies that extend beyond the health sector such as economic empowerment of women could be effective in mitigating the economic impact of illness amongst female headed households in Zimbabwe.

This study reviewed community-based directly observed treatment and the conventional approach to tuberculosis management in order to find cost-effective approach. Both patient and health system cost data were used. Hospital cost data were collected from a mission hospital in rural Zambia for the periods 1989 and 1997. Patient cost data were collected from a sample of 50 patients in terms of time and travel costs. The cure rate was used as the measure of effectiveness. Results showed that community-based DOT is the most cost-effective approach because of its reduced costs to the patients and health system. Finally, it was also found that community-based DOT is the most viable economic option given the existing resource constraints. Suggestions for future study are offered and limitations of research are explored.

Includes bibliographical references ( leaves 85-88). / This study focuses on assessing health provider preparedness in the move towards the implementation of national health insurance with specific reference to the Upper West Region. The paper uses both quantitative and qualitative methods to review the level of knowledge of health staff on the concept of health insurance, the availability of health professionals, essential drugs, infrastructure and equipment, which are essential for providing quality health care.

Includes bibliographical references (leaves 101-110). / The study primary objective was to investigate the determinants and extent of household’s reliance on the informal malaria care sector in two Ghanaians communities. The secondary objective wass to inform policy-makers and planners, especially from the public healthcare sector, on supply side issues that are likely to influence the current malaria care seeking patterns.

Includes bibliographical references (p. 96-103). / The study seeks to assess South Africa’s health care utilisation pattern in the post apartheid era. This is based on the equity driven policy objectives of the health care system that were meant to have impact on individuals’ health care utilisation patterns. A framework of factors influencing health care utilisation is outlined to explain the determinants of health care utilisation. It gives some insights into the socio-economic and racial differences influencing the use and choice of health care in South Africa. It also attempts to investigate how these factors have changed and whether the pattern of health care utilisation among those with higher need has changed over time.

Includes abstract. / Includes bibliographical references. / The higher increase in the number of HIV/AIDS patients in the country has necessitated the expansion of Home Based Care (HBC) programmes and has called for the need to strengthen the HBC services in Tanzania. Since scaling up of HBC services is fundamental and the resources dedicated into HBC programs are supposed to be utilized efficiently, the factors hindering the provision of HBC services should be known and resolved. A cross sectional study was applied in studying the factors that influence the provision of HBC services and a quantitative method of data collection and analysis was used. A sample of 8 civil society organisations out of 23 carrying out HBC activities under 'Hope' HBC program were selected, representing organizations from rural and peri urban areas.

Includes abstract. / Includes bibliographical references. / Malaria is no doubt a severe public health problem especially in sub-Saharan Africa. It is endemic in Nigeria and insecticide-treated mosquito nets have been found to be effective in its control. However, the cost of commercially-sold ITNs in Nigeria is considered to be beyond the reach of many households. Therefore, it is essential to ascertain how much the average rural household is willing to pay for a family-size ITN.