PAPER WRAP-UP: Microfinance Investments in Quality at Private Clinics in Uganda: A Case-Control Study by Eric E. Seiber and Amara L. Robinson

Written by Eric E. Seiber of the College of Public Health at Ohio State University and Amara L. Robinson of BioMed Ltd., and based on research conducted by BioMed Central Ltd. (BMC), published October 18, 2007 as a 12-page document available here.

This report examines the potential for small private-sector health care providers including pharmacists, nurses, midwives and doctors to improve access to quality preventive and curative health services in Uganda with the aid of micro-credit and business training.

The study examines 29 private clinics divided into two groups: those that received micro-loans and business training to aid in their business expansion (22 clinics) and those that did not receive aid (7 clinics). Approximately two thirds of the clinics were located in peri-urban areas. Loans were provided by USAID‘s Summa Foundation. Data was collected from 2,387 client-exit questionnaires between October 2001 and November 2002. Questionnaires were based on client-perception of services, quality of care, and client loyalty.

Loans were disbursed to private clinics on a revolving basis. The average loan size was USD 920 to be used as working capital, to purchase drugs or equipment, or to renovate of upgrade the clinic. Most first-time borrowers (82.9 percent) used part of their loan to increase drug stocks, while nearly half of the loan recipients used part of their loan to buy equipment. Twenty-seven percent of loan recipients used part of their loan to renovate or expand their clinics.

Respondents were most concerned with the availability of drugs, fairness of charges, and cleanliness and physical appearance of clinics. Because loan recipient clinics were able to improve their services and increase their drug stocks, they were perceived by clients as being of superior quality than non-loan recipient private clinics and crowded public facilities.

Though private clinics are also an important provider of reproductive health services to women, HIV prevention, and other general health services, clients surveyed were most concerned with the availability of malaria medication. Clients returned to loan-recipient clinics for malaria medication and were willing to pay higher fees for higher-quality services, citing the region’s public health clinics as being overcrowded and undersupplied.

The study concluded that private health clinics run by mid-wives, nurses, pharmacists and doctors fill an important gap in Uganda’s health care needs. These private clinics are often constrained by lack of funds.

By Melissa Duscha

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