Effect of Removing Direct Payment for Health Care on Utilisation and Health Outcomes in Ghanaian Children: A Randomised Controlled Trial
2009

Impact of Removing User Fees on Health Care in Ghanaian Children

Sample size: 2592 publication Evidence: low

Author Information

Author(s): Evelyn Ansah, Slim Haddad

Primary Institution: Université de Montréal

Hypothesis

Does removing user fees improve health care utilization and health outcomes in Ghanaian children?

Conclusion

The study found that removing user fees did not significantly improve health outcomes or health care utilization among Ghanaian children.

Supporting Evidence

  • Moderate anaemia was detected in 3.1% of children in the control group and 3.2% in the intervention group.
  • There were four deaths in the control group and five in the intervention group.
  • Health care utilization was higher in the intervention group but only modestly so.

Takeaway

The study looked at whether not charging for health care helps kids get better care, but it found that it didn't really make a difference.

Methodology

A randomized controlled trial comparing a pre-payment scheme allowing free primary care to a control group paying user fees.

Potential Biases

Potential biases due to the limited scope of health outcomes assessed and the low prevalence of anaemia in the control group.

Limitations

The study only focused on children and specific health outcomes, which may not represent the overall effectiveness of the pre-payment scheme.

Participant Demographics

Households with children under five years old in the Dangme West District of Ghana.

Statistical Information

Confidence Interval

95% CI, 0.66–1.67

Digital Object Identifier (DOI)

10.1371/journal.pmed.1000007

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