Health Cards (28)
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Colleagues,
As is usual in health/medical debates, users' perspectives are often the
least to be taken into consideration. The discussion on health cards is
no exception. Since there is such money to spend on advancing technology
in patient records keeping, would it not have been more useful to find
out the perspectives of the individuals (that would eventually be
required to carry such card) on the cards, as a necessary first step.
Has any survey of any form (whether RAs, randomised etc.) been carried
out to determine the perspectives of potential carriers of the card? I
will be interested in the results. At a time when we are emphasising the
importance of patient/community 'self-reliance and self-determination'
in health care initiatives, I do not see why this work should go any
further without a clear knowledge of what the potential carriers think
about it and how to incorporate such knowledge in further work on the
cards.
My second worry with the health cards is the cost to the individuals
whether they are U-5s or adults. Will these cards be issued free of
charge? Will they be mandatory? A major problem in our part of the world
is that some public officers (in a position to do so) see any 'official'
document as a means to extort money from those required to carry it. A
very likely situation that will develop with the introduction of this
card (even if they are issued freely) is that some health workers who
see it as an opportunity to make money out of poor and already
over-burdened health care seekers will hoard the cards and then ensure
that access to services is denied to those not carrying it. When this is
done, the 'cost' of the card could then be arbitrarily fixed according
to which health worker is being seen. How would this form of abuse be
checked to ensure that people do not end up spending all their meagre
health care finance merely to obtain a health card?
Golda Chimere-Dan
Population Research Programme
University of the Witwatersrand
Johannesburg
South Africa
mailto:claj@iafrica.com
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