02340nas a2200361   4500000000100000008004100001260001300042653001000055653001000065653002000075653002000095653002100115653002100136653001100157653001800168653002000186653001900206653001100225653002100236653001200257653000900269653001200278653001400290653002400304100001600328700001600344245012600360300001000486490000700496050001900503520144200522022001401964       2006                            d  c2006 Jul10aAdult10aChild10aData Collection10aDecision Making10aEndemic Diseases10aFees and Charges10aFemale10aHealth policy10aHealth Services10aHIV Infections10aHumans10aLocal Government10aMalaria10aMale10aNigeria10aPregnancy10aPrimary Health Care1 aUzochukwu B1 aOnwujekwe O00aExemption policies and community preferences for tropical endemic diseases in the Bamako initiative programme in Nigeria.  a132-60 v36  aUZOCHUKWU 20063 a<p>We determined the actual written policies/guidelines and practices of fee exemptions aimed at the primary health-care level for tropical diseases treatment within the Bamako initiative system and the community's and decision makers' preferences for exemption in Nigeria. Health policy documents from the federal and state ministries of health were reviewed to determine the guidelines for exemptions, services, goods and category of people to receive exemptions. The records of the local government areas, health centres and community health committees were also reviewed to check who had received exemptions and modalities for doing so. In addition, household surveys using questionnaires was conducted. There is no clear-cut national policy regarding exemption. In areas where exemption exists, these are largely unofficial, as no official documents exist to support exemption. A total of 1594 individuals were surveyed. Community members prefer pregnant women, children and patients with TB, malaria, onchocerciasis and leprosy to be exempted from payment of fees: decision makers prefer the poor, children and patients with malaria, TB and leprosy to be exempted from payment for drugs, registration, consultation and preventive services such as immunization and antenatal services. One area of divergence between the preferences of the community and decision makers is the issue of exempting people with malaria and HIV/AIDS.</p>  a0049-4755