Abstract removing user fees could improve service coverage and access, in particular among the poorest socio-economic groups, but quick action without prior preparation could lead to unintended effects, including quality deterioration and excessive demands on health workers this paper illustrates the. Lagarde, m and palmer, n (2008) the impact of user fees on health service utilization in low-and middle-income countries: how strong is the evidence bulletin of the world health organization, 86(11), 839–848c lagarde m, palmer n the impact of user fees on access to health services in low- and middle- income. Removal of user fees at primary health care facilities in zambia: a study of the effects on utilisation and quality of care felix masiye, bona mukosha chitah, pascalina chanda and felix simeo department of economics, university of zambia with health economics unit, university of cape town in the regional network. The impact of user fees on access to health services in low- and middle-income countries (review) lagarde m, palmer n this is a reprint of a cochrane review, prepared and maintained by the cochrane collaboration and published in the cochrane library 2011, issue 4. The momentum towards achieving the united nations millennium development goals re-invigorated concerns around sustainable health care financing and the adequacy of the financing arrangements in many low-resource settings accordingly, this necessitated the institution of user-fees as part of health financing reform. Raising the price of a good or service has two effects: it reduces demand and increases supply in the case of user fees for health, it was thought that paying for a service also makes people use it more appropriately (you don't go to the doctor for minor ailments) and value it more than if they obtained it for. Disrespectful care from health workers6 while the removal of user fees addresses some of the financial barriers to access, women and children in need of maternal and neonatal health care may be facing a whole host of other barriers that remain unaddressed by this policy while there are many studies on the effect of user.
The current income limit for free prescriptions (which was â£15,276 per family via the tax credit system) is so low that adverse health impacts such as those described by the authors may be occuring in those with below average incomes, but above the current income limit for exemption from charges. The international development discourse presents numerous, often interrelated, rationales for the introduction of user fees in the health sector, relating inter alia to cost recovery, improved equity and greater efficiency (price 2002) a major argument for the generation of revenues through cost-recovery strategies based on. This chapter is concerned with the issue of user fees (or user charges) for public health services we discuss the implications of user fees for cost%effectiveness, alloca% tive effi ciency, equity, progressivity of public health care spending, and quality of service each of these is a desirable end in itself, and so each is an.
The impact of the abolition of user fees in south africa, a policy implemented in 1994 for children under the age of six and the elderly, as well as pregnant and nursing mothers, is examined via regression discontinuity the analysis focuses on the use of public health care facilities for the receipt of curative. User charges in health care: evidence of effect on service utilization & equity from north india shankar prinja, arun kumar aggarwal, rajesh kumar & panos kanavos school of public health, post graduate institute of medical education & research, chandigarh, india & london school of economics & political. The price of labor: evaluating the impact of eliminating user fees on maternal and infant health outcomes by anne fitzpatrick∗ the pricing of healthcare products and services, particularly for the poor, has generated substantial debate in the economics and public health literature advocates argue that fees improve.
The poor are negatively affected by user fees in other ways, too a study looking at the effects of prescription drug user fees found that low-income patients were more likely to stop taking medications to treat chronic disease these results are not surprising, as in the rand study adverse health effects. Bull world health organ 2008 nov86(11):839-848 the impact of user fees on health service utilization in low- and middle-income countries: how strong is the evidence lagarde m(1), palmer n author information: (1)london school of hygiene and tropical medicine, london, england [email protected] Objectives evidence on whether removing fees benefits the poorest is patchy and weak the aim of this paper is to measure the impact of user fee reforms on the probability of giving birth in an institution or undergoing a caesarean section (cs) in ghana, burkina faso, zambia, cameroon and nigeria for the poorest strata of. Due to the relative scarcity of public resources, governments are more and more wondering whether to increase user participation in financing health care by imposing user charges opinions differ, however, as to the potential impact of such increased user participation while some maintain that user fees will make it.
Following an international push for financing reforms, many low- and middle- income countries introduced user fees to raise additional revenue for health systems user fees are charges levied at the point of use and are supposed to help reduce 'frivolous' consumption of health services, increase quality of services available. Removing user fees for primary health care services in rural districts in zambia and for children over five years old in niger increased use of services by the targeted groups the impact of the policy change differed widely across districts, ranging from 112% and 1194% in niger to 239% and 1108% in zambia eighteen. Health is a human right and, for many in the developing world, a desperate need however, we want this new policy to be introduced smoothly, without unintended negative consequences, and recognising that abolishing user fees must be just one part of a wider strategy of strengthening health systems and financing those.
On the other hand, includes private insurance (financed through insurance premiums) and out-of-pocket costs (paid directly by patients) this last category, out-of-pocket payments, is often referred to as patient user fees different healthcare systems use different combinations of these three options to different effects. 1 user fees in primary healthcare in sub‐saharan africa: a study of the effects and legacy of world bank neoliberal health policy angela guo april 4, 2012 international studies, bs honors thesis.
839 bulletin of the world health organization |november 2008, 86 (11) the impact of user fees on health service utilization in low- and middle-income countries: how strong is the evidence mylene lagardea & natasha palmera introduction access to basic health services of accept- able quality is still denied to many of. Researchers in the cochrane collaboration conducted a review of the impact of user fees on people's access to health services in low- and middle-income countries after searching for all relevant studies, they found 16 studies their findings are summarised below user fees and people's use of health. Abstract objective to assess the evidence of the impact of user fees on maternal health service utilization and related health outcomes in low- and middle-income countries, as well as their impact on inequalities in these outcomes methods studies were identified by modifying a search strategy from a.