Abstract:
The purpose of the study was to investigate the factors that hinder effectiveness in the
management of waiver system. The study used a cross-sectional design. Interview
schedules, questionnaires and document review approaches were used to collect the data.
Purposive sampling method was used to obtain key informant respondents from the
hospital staff while simple random sampling and systematic sampling was used to obtain
patient respondents. The population of this study was composed of patients at the
hospital as well hospital staff involved in the management of waiver system. Data
collected was analyzed using the Statistical Package for Social Sciences (SPSS). Frequency
counts and percentages were used to describe the data. Among the major findings the
study showed that there were no long term plans for waiver system operation and there
was no inclusion of its related costs in the annual budgeting process. There was poor
utilization of the waiver system among potential beneficiaries despite more than half of
the patients knowing that a waiver system existed at the hospital, three waived patients
per month was the norm; Age of the patient respondent was statistically significant on
waiver application (X2 = 10.22, p = 0.015). Occupation, education and income level were
not significant factors in waiver application. However, Stock out of drugs, supplies, lack
of information dissemination on waivers, difficulty in beneficiary identification and poor
operating structure for the waiver system were some of the factors identified to hinder
effectiveness in the management of the waiver system. On the basis of the findings the
study recommended that there was need for the development of enforcement mechanisms
for issued guidelines under the waiver system such as monitoring and evaluation of the
waiver system on a prescribed time frame and the establishment of an effective and
efficient operating framework structure.