Since independence in 1975, Cape Verde has made significant progress in providing basic health care to its population. The national health budget is one of the largest in Africa. But with rising health care costs and an aging population, officials say they can no longer pay as much. Phuong Tran has more from Praia, Cape Verde on the campaign to get residents to pay for doctor visits.
In this government-run hospital maternity ward in the capital of Cape Verde, mothers and pregnant women typically do not pay. They come in for a visit, but rarely see a bill or open their wallets.
No one here has ever asked them for money.
But the director of Health Services, Jacqueline Pereira, says the government can no longer afford to pay such a large portion of the health care bill for its half million residents.
Pereira explains that costs are going up because most illnesses doctors treat are chronic diseases rather than infections that can be solved in one doctor's visit. She says health officials need patients to start paying based on their income.
The government is trying to convince people that if they do not start paying into the public health care system, their own health care will suffer.
But Pereira knows it may be difficult to convince people.
She says most people consider free health care a right, rather than a luxury. She says the government's posters and radio announcements that have run since the beginning of the year explain that more funds means new technology to treat increasingly complicated diseases.
Donors have recently given millions to treat the growing rate of HIV infection in rural zones, women and youth, but Pereira says there are many other health needs, such as diabetes care.
Pereira says the government is ready for some resistance, but people are starting to understand how their health care will suffer if they do not contribute to their health care costs.
According to the World Health Organization, in 2003, the Cape Verde government spent about five percent of its annual budget on health care, covering about three quarters of all the island country's costs.