Facility User's Preference between the Free and the Bamako Initiative (Drug Revolving Fund-Based) Health Services in Iwajowa Local Government, Oyo State

Abstract

Background: The Drug Revolving Fund (DRF) was instituted in 1996 in Oyo State to ensure sustainable drug availability at primary health care level with a seed stock of drugs supplied by the Petroleum Trust Fund. This was discontinued in 1999 and replaced in January 2000, with free health service, which involves supplying free drugs from the state medical store to local government areas. This study aimed to determine which of these two was preferred by health facility users in terms of drug availability and health services provided during a 2-year period of implementation of each.

Methodology: This cross-sectional study was conducted in the catchment areas of the health centres which were in existence prior to 1998 within Iwajowa LGA. A total sample of all community members aged 25years and above who had been using the health centres prior to or up to 1998 were enrolled in the study. A structured questionnaire was used to collect data on patronage and drug availability during both periods.

Results: Respondents totaling 1882 were surveyed; 260 (14.0%) had stopped patronizing the health facilities after commencement of free health. Major reason among others was lack of drugs reported by 92 (39.4%) respondents. More facility users 1151 (62.6%) preferred the DRF scheme in terms of drug availability while 660 (36.0%) preferred free health; 375 (81.1%) of those who preferred free health did so because it was cheap. A sizeable percentage (36.6%) of respondents requested for continuation of free health.

Conclusions: Findings showed that most users preferred the DRF to free health scheme. It is suggested that communities can set up their own DRF scheme at the health facility within their ward.

Keywords: Bamako initiative, drug revolving fund, essential drugs, free health, Health care financing, drug availability