FRONTIERS Projects | Improved Utilization of Services and Enhanced Cost Recovery Through Implementation of an Afternoon Clinic

FRONTIERS PROJECT
Improved Utilization of Services and Enhanced Cost Recovery Through Implementation of an Afternoon Clinic

FRONTIERS assisted the Chhetrapati Family Welfare Center (CFWC) in an operations research project that examined whether introducing an afternoon clinic could improve cost recovery. The services—which included general health checkups, immunizations, and OB/GYN and family planning services—were offered between 3 and 5 p.m., during which time patients were charged a substantially higher consultation fee.

Outreach and in-reach activities were used to raise awareness about the afternoon services among residents within the CFWC catchment area. A monitoring system was established to capture utilization, cost, and revenue data.

The study showed that the afternoon clinic was underutilized, and the clinic did not successfully reach target cost recovery. The use of afternoon services remained very low (2–3 clients per afternoon as compared to 120 per day in the morning clinic). Qualitative inquiry showed that it is widely believed that family planning specialists are not the best choice for general checkup or other curative services.

Upon completion of the study, the CFWC considered the recommendations for a more successful program including the need to change client perceptions about the ability of CFWC providers to provide non-family planning services in order to increase the volume of afternoon clients. It was also noted that a reduction in the price discrepancy between morning and afternoon clinics would facilitate shifting of clients from the crowded morning hours to the less crowded afternoon sessions while still helping to increase cost recovery.

Location

Kathmandu, Nepal

Duration

May 2005–February 2006

Population Council researchers

M.E. Khan, Pradeep Panda

Non-Council collaborators

Rick Homan (Family Health International)

Mahendra Pd. Shrestha, Rajesh Swar (Nepal Fertility Care Center)

Donor

US Agency for International Development

Publications/Resources
Council researchers' names appear in boldface type.

2007
Shrestha, Mahendra Pd., Rajesh Swar, Pradeep Panda, M.E. Khan, and Rick Homan. "Effect of introducing an 'afternoon pay clinic' on service utilization and cost recovery (Nepal)," FRONTIERS Final Report. Washington, DC: Population Council. (PDF, 120 KB)