The negative impact of user fees on th
e utilisation of the health
services by the poor in
developing countries such as Uganda
and Jamaica is well documented. Therefore
,
various
governments hav
e been engaged in reforming
public health system
s
to increase access by
underserved populations. One such reform is the introduction of free health services. In
Jamaica, user fees were ab
olished in the public health sector in 2007 for children under 18
years and in 2008 free health care was introduced for all users of the public health system.
This study evaluated the impact of the 2008 reform on the Jamaican public health system
at 1) th
e national level, 2) the provider level
,
and 3) the user level. Perspectives were
sought on access to care, the care provided
,
and the work of the professional nurse.
Participants were selected from the Ministry of Health (MOH), the four Regional Health
Authorities (RHAs)
,
and urban and rural health facilities.