Community Perception of Exemption Policy and Implementation of the Policy in Assin District

Abstract

This study examines the perceptions of the communities in Assin District with respect to exemption policy and its implementation. A combination of interviews and discussion with community groups was used. A total of 86 people were interviewed. This comprised mothers caring for children under 5 years, pregnant women, the Aged (70+years) and people not entitled to any exemptions. Three focus groups were organized. This study was necessitated by the fact that most patients in the district still stayed off public health facilities on the basis of financial constraints despite the exemption policy and the high expenditure of the District Health Administration on exemption. The level of awareness about the policy is high but the knowledge about policy statement is grossly inadequate and most of it erroneous. Only small proportion of respondents had information on exemption from Health workers. The community perceived anything given out free of charge as of poor quality. The community members could not provide an operational definition for “poor” It was found that “financial constraint” as used by members of the community with respect to seeking health care does not necessarily imply inability to pay “user charges” but it also may mean cost of reaching the facility. The community members were of very low self-esteem and could not imagine how they could make input into national policies or demand for a change in policy. The study was carried out in a rural setting among people with basically low educational background. This is based on the fact that literacy rate in Ghana is just over 55%. It is believed that most of the illiterates live in the rural areas of the country.