Maputo, 14 Jun (AIM) – The Citizen Observatory for Health (OCS), a non-governmental coalition, has warned that the user fees, which patients must sometimes pay to access the health system, constitute a barrier for the poorest people in Mozambique.
According to the executive director of OCS, Jorge Matine, speaking to the press on Tuesday in Maputo, a study entitled “Socio-economic Effects of User Fees in the Health Sector”, shows that the user fee is not efficient, as it constitutes a barrier to citizens’ access to health services.
“The study shows that the user fee harms users, and it also shows that the cost of collection is greater than the benefit. It means that the state spends more by paying the people who collect the user fee than the income obtained from the fee”, he said.
The source explains that the fee is not only charged at the entrance to the hospital, but for each service requested. For this reason, the user fee can reach 1,500 meticais (about 23.5 US dollars, at the current exchange rate), against the initial and officially established fee of 50 meticais, an amount that can also change depending on the service.
“The fee varies from 500 to 1,500 meticais, but because there is no organization on how they should be charged, these fees are not only charged at the entrance, but also in the various services”, Matine said, adding that there are many cases identified during the study, where patients were supposed to take their own equipment to the hospital, including water.
As a solution to the problem, the OCS proposes, in addition to the elimination of the user fee, the implementation of other ways of financing the health system, such as the adoption of a Universal Insurance system that could cover the costs for the treatment of patients who are victims of work accidents, for example.
“It is from these fiscal steps that we think the government can get the money, and not in the citizen’s pocket”, adds the OCS executive director.
For his part, Edmilson Mavie, representing the Department of Quality Management and Humanization at the Maputo Central Hospital (HCM), said that the conception of the user fee, taking his institution as an example, aims to reduce the use of quaternary level hospitals (central hospitals) without need.
“But it also works, as the study presented, as an alternative income for financing, given the scarcity of resources”, he said.
He also explains that patients who go to quaternary level hospitals with a transfer form are exempted from paying the user fee. Thus patients who use the health service’s referral system do not have to pay the fee. But someone who choses to go straight to the HCM, without passing through a peripheral health unit first, must pay the user fee.
The study was conducted during 2022, and covered 400 hospitals from primary to quaternary level, in five provinces of the country.
(AIM)
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