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Alternatives to user fees for public health care
Mamdani, Bashir
Mamdani, Bashir
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"Poor people use preventive and curative public health care services far less than the well-off. User fees, a widely used strategy to supplement governmental resources, further aggravate the situation. Five years after Uganda eliminated user fees at government health facilities, outpatient attendance, particularly by the poor, doubled. In Cambodia too there was increased use of health services by the poor in hospitals participating in third-party insurance schemes, or health equity funds, which waived fees selectively. This demonstrated that there was a huge unmet need for health care. Should scarce health resources be provided to all or selectively to the poor in a low-income country? The authors discuss the experience of Uganda, which eliminated user fees, and Cambodia, which established a health equity fund to finance care for the poor. They identify some key issues that national policy makers should consider before formulating a strategy. Barriers to health care
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2007-07
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With permission of the license/copyright holder