Removing User Fees in the Health Sector in Low-Income Countries: A Policy Guidance Note for Programme Managers
Published 1 January 2009
Bruno Meessen
Citations12
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The designations in this publication do not imply an opinion on legal status of any country or territory, or of its authorities, or the delimitation of frontiers.
Abstract
© United Nations Children's Fund (UNICEF), New York, 2009 UNICEF 3 UN Plaza, New York, NY 10017 September, 2009 This is a working document. It has been prepared to facilitate the exchange of knowledge and to stimulate discussion. The text has not been edited to official publication standards and UNICEF accepts no responsibility for errors. The designations in this publication do not imply an opinion on legal status of any country or territory, or of its authorities, or the delimitation of frontiers.
Keywords
Social SciencesMedicineNursing
Health Policy and PlanningOvercoming barriers to health service access: influencing the demand side
877 Citations2004Tim Ensor
Demand barriers present in low- and middle-income countries and evidence on the effectiveness of interventions to overcome these obstacles are reviewed, suggesting that while barriers are plentiful, there is a dearth of evidence on ways to reduce them.
Social Science & MedicineUnderstanding the impact of eliminating user fees: Utilization and catastrophic health expenditures in Uganda
357 Citations2005Ke Xu, David Evans +5 more
RePEc: Research Papers in EconomicsTargeting of Transfers in Developing Countries: Review of Lessons and Experience
348 Citations2004David Coady, Margaret Grosh +1 more
The LancetUniversal health care and the removal of user fees
341 Citations2009Robert Yates
A detailed analysis of the research shows that user fees have failed to deliver on all the success criteria outlined in the 1987 agenda for reform report and are most pronounced in the suppression of demand for health care by poor people.
Bulletin of the World Health OrganizationThe impact of user fees on health service utilization in low- and middle-income countries: how strong is the evidence?
278 Citations2008Mylène Lagarde
Removing or reducing user fees was found to increase the utilization of curative services and perhaps preventive services as well, but may have negatively impacted service quality, although quality improvements may have helped maintain utilization in some cases.
Applied Health Economics and Health PolicyTo Retain or Remove User Fees?
253 Citations2006Chris James, Kara Hanson +13 more
Reflections on the recent user fees debate are provided, drawing from the evidence presented and subsequent discussions at a recent UNICEF consultation on user fees in the health sector, and relates the debate to the wider issue of access to adequate healthcare.
BMJRemoving user fees for primary care in Africa: the need for careful action
236 Citations2005Lucy Gilson, Di McIntyre
Health Policy and PlanningThe elasticity of demand for health care in Burkina Faso: differences across age and income groups
136 Citations1994Rainer Sauerborn, A. Nougtara +1 more
A logistic regression model is presented to derive price elasticities of demand for health care based on cross-sectional survey data in Burkina Faso, which allows estimation of elasticities before the introduction of user fees.
The World Bank eBooksImproving Health Service Delivery in Developing Countries
123 Citations2009David H. Peters, Sameh El-Saharty
This book pulls together available evidence concerning strategies to improve health services delivery in low- and middle-income countries (LMICs), using current methods to assemble a knowledge base and analyze the findings.
Bulletin of the World Health OrganizationOutput-based payment to boost staff productivity in public health centres: contracting in Kabutare District, Rwanda
112 Citations2007Bruno Meessen
Assessment of health care centres in Kabutare, Rwanda found changes to the structure of contracts were associated with improvements in health centre performance, and output-based performance contracts induced sharp increases in the productivity of health staff.
The LancetPoverty and user fees for public health care in low-income countries: lessons from Uganda and Cambodia
101 Citations2006Bruno Meessen, Wim Van Damme +2 more
In Uganda the abolition of user fees was accompanied by a substantial investment in the health-care system and in Cambodia the health equity funds were introduced in hospitals whose performance had been improved by contracting arrangements establishing higher staff motivation and improved quality of care.
Queen Margaret University Publications Repository (Queen Margaret University)Freeing-up Healthcare: A guide to removing user fees
19 Citations2008Barbara McPake, Andrea E. Schmidt +2 more