The Impacts of User Fees on Health Services in Sub-Saharan African Countries: A Ctirical Analysis of the Evidence

Ejughemre Ufuoma John^1,

¹Department of Community Medicine, Delta State University Teaching Hospital, Oghara, Delta State, Nigeria

Cite this paper

Ejughemre Ufuoma John. The Impacts of User Fees on Health Services in Sub-Saharan African Countries: A Ctirical Analysis of the Evidence. American Journal of Public Health Research. 2013; 1(8):196-202. doi: 10.12691/AJPHR-1-8-1

Abstract

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 in many countries in sub-Saharan Africa. These fees are charges levied at the point of service with the intent of reducing ‘frivolous’ consumption of health services, increasing the quality of services available and at the same time increasing coverage and utilisation of services. Likewise, as a ‘decisive’ policy to cushion the existing challenges facing health care financing in the region, a critical assessment of the assertions of proponents of user fees who use the principle of cost recovery and revenue mobilization to drive the concept of rational utilization, efficiency and equitable distribution of health care services is often exaggerated. As it were, the available evidence suggests that user fees alone will not likely accomplish equity, efficiency, or the sustainability objectives in health services in the region. What is critical is that user fees should be linked to the broader package of financing -such as insurance coverage- and with a view to averting any form of equity danger that may thus arise.

Keywords

user-fees,utilization, equity, quality, health services, sub-Saharan Africa

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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