User fees for health care: a new key issues guide
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Please find details below of a new Eldis Health Systems key is-
sues guide which I hope will be of interest to AFRO-NETS sub-
scribers.
User fees - killer bills or vital funds?
User fees for health care are widespread around the developing
world, but opposition to them is growing. Many studies have
found them to be a barrier to the use of health services, par-
ticularly among poor people. Amid concerns that they will pre-
vent the Millennium Development Goals from being met, research-
ers, advisers, and policy makers have questioned whether user
fees should be applied at all.
Yet there are reasons to be cautious about abolishing user fees.
Other financial barriers - such as the cost of purchasing drugs,
unofficial fees, and transport costs - are often more important
than user fees, and abolishing them would remove a relatively
small, but often vital source of funding. Unless this funding is
replaced from other sources, there could be adverse consequences
for quality of service. User fees may also be a necessary part
of other mechanisms for financing health care, such as insurance
schemes. They therefore have to be seen within the broader con-
text of health systems financing.
Produced in collaboration with the DFID Health Resource Centre,
this new Eldis Health Systems key issues guide examines evidence
on the impact of user fees and presents some of the ongoing de-
bates in health financing policy. It considers arguments for and
against abolishing fees, and provides recommendations for donors
and governments on how fees should work if they are kept.
Access the guide at:
http://www.eldis.org/healthsystems/userfees/
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Stuart Cameron
Research Assistant, Health Resource Guides
Institute of Development Studies, UK
Tel. +44-1273-873-335
mailto:S.Cameron@ids.ac.uk
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