Out-of-pocket health payments and catastrophic expenditures
User fees
User fees - direct charges to users for health services - have been implemented in many countries for a number of years now. Proponents of user fees suggest that fees could make the health system more efficient by guiding demand to cost-effective health care at the appropriate levels. Further, they could improve equity if revenues generated from fees are allocated to addressing the health needs of the poor. Others, though, argue that this reallocation is not guaranteed, and in the absence of exemption policies or other forms of financial protection, user fees actually price the poor out of the market for health care. The discussion paper below reviews the African experience with user fees.
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User-fee
pdf, 299kb
Building on the user-fee experience: the African case