TY - JOUR
T1 - The behaviour of health workers in an era of cost sharing
T2 - Ghana's drug cash and carry system
AU - Asenso-Okyere, W. K.
AU - Osei-Akoto, Isaac
AU - Anum, Adote
AU - Adukonu, Augustina
PY - 1999
Y1 - 1999
N2 - This qualitative study aimed to assess possible changes in prescription patterns and resultant implications for the quality of care delivered in three southern districts of Ghana after the introduction of a full cost recovery scheme for drugs in 1992. While the availability of safe and effective drugs has improved especially in rural areas, not all patients are able to meet the cost for required medication. This has influenced the behaviour of most prescribers, who now take economical limitations into account. As a result, poorer patients may either take fewer drugs or smaller quantities than medically indicated, with possible ensuing consequences for public health. Overall, the cash-and-carry scheme does not appear to have changed health workers' attitudes towards patients; where such behavioural changes occurred they seemed to be due to personnel shortages. Generally, patients in rural facilities reported greater satisfaction with the care they received than urban residents; and medical assistants were perceived as friendlier than both nurses and doctors.
AB - This qualitative study aimed to assess possible changes in prescription patterns and resultant implications for the quality of care delivered in three southern districts of Ghana after the introduction of a full cost recovery scheme for drugs in 1992. While the availability of safe and effective drugs has improved especially in rural areas, not all patients are able to meet the cost for required medication. This has influenced the behaviour of most prescribers, who now take economical limitations into account. As a result, poorer patients may either take fewer drugs or smaller quantities than medically indicated, with possible ensuing consequences for public health. Overall, the cash-and-carry scheme does not appear to have changed health workers' attitudes towards patients; where such behavioural changes occurred they seemed to be due to personnel shortages. Generally, patients in rural facilities reported greater satisfaction with the care they received than urban residents; and medical assistants were perceived as friendlier than both nurses and doctors.
KW - Attitude
KW - Cost-sharing
KW - Discriminatory pricing policy
KW - Drug supply
KW - Ghana
KW - Government health facility
UR - http://www.scopus.com/inward/record.url?scp=0032845022&partnerID=8YFLogxK
U2 - 10.1046/j.1365-3156.1999.00438.x
DO - 10.1046/j.1365-3156.1999.00438.x
M3 - Article
C2 - 10499083
AN - SCOPUS:0032845022
SN - 1360-2276
VL - 4
SP - 586
EP - 593
JO - Tropical Medicine and International Health
JF - Tropical Medicine and International Health
IS - 8
ER -