PHM-Exch> Health user fee removal in low-income countries: lessons learned

[Claudio Schuftan]

From: Ruggiero, Mrs. Ana Lucia (WDC) <ruglucia at paho.org>
crossposted from : EQUIDAD at listserv.paho.org


** ** ** ** ** **

*User fee removal in the health sector in low-income countries:
**lessons from recent national initiatives

***

Edited by Bruno Meessen, Lucy Gilson and Abdelmajid Tibouti****

*Health Policy and Planning - Volume 26, Supplement 2 - November 2011

*

Available free online at: http://bit.ly/zTUg1n

****

*This supplement, sponsored by Unicef*, focuses on the challenges related
to the design and implementation of user fee removal policies in low-income
countries.

****

"User fees have triggered impassioned discussions in international health
over the last two decades. Promoted by a number of international
organizations since the late 1980s as a strategy to finance struggling
public health facilities in many low-income countries, recent years have
seen growing criticism of the impact of fees on access to health services,
particularly for the poorest groups..... ****

In mid-2008, UNICEF approached a group of researchers with the request to
document recent experience with user fee removal. While aid actors in the
North were still arguing fiercely about the pros and cons of user fees, a
growing number of countries had already decided to remove user fees, at
least for some priority services.... A consensus was easily reached between
*UNICEF and the research team led by the Institute of Tropical Medicine,
Antwerp*: the multi-country review would not (again) focus on evidence
against or in favour of user fees, but would instead try to document how
countries formulated and implemented user fee removal. ****

This focus was seen as valuable because it could generate practical lessons
for other countries interested in such a step....  the research team judged
that the main question of the multi-country review—the challenges related
to design and implementation of user fee removal policies—deserved more
visibility than just another report....****

Our objectives for this supplement were multiple. From the start we decided
we would welcome contributions from different regions and fields of
expertise, as the supplement had to be useful for researchers, but also for
programme officers and policy makers directly involved in health care
financing policies in low-income countries. We acknowledged that
contributors would adopt different types of methodological approaches to
address different questions. We were also keen to get contributions from
the different ‘corners’ of the user fee debate. Experts familiar with the
controversy can see for themselves that this objective has been achieved; a
glance at the list of contributors to this supplement suffices...."

****

*The full supplement is available free online:
Volume 26 suppl 2 November 2011

*

*User fee removal in low-income countries:
sharing knowledge to support managed implementation** *[Editorial].

****

Bruno Meessen 1,*, Lucy Gilson 2,3 and Abdelmajid Tibouti 4****

1Department of Public Health, Institute of Tropical Medicine, Antwerp,
Belgium, 2School of Public Health and Family Medicine, University of Cape
Town, South Africa, 3Department of Global Health & Development, London
School of Hygiene and Tropical Medicine, London, UK and 4UNICEF, New York,
USA ****

http://bit.ly/ytNMUA

****

“………..As international organizations, development partners have also a
major responsibility in terms of knowledge management. It is our firm
belief that real efforts must be made at regional level to bring together
relevant knowledge—not just formal evidence—to support fee removal and
improvements in financial access. A top priority should be to remove the
walls between the different ‘niches’ of knowledge: policy makers,
scientists, operational actors and aid agencies must learn to develop
knowledge together (Meessen et al. 2011). Countries should also better
share lessons of experience and good practices. There is, therefore, a need
for much better collective learning……….”

****

*Removing user fees for health services in low-income countries: a
multi-country review framework for assessing the process of policy change*

http://bit.ly/xV1J1H ****

*Removing user fees in the health sector: a review of policy processes in
six sub-Saharan African countries*

http://bit.ly/wsVwkl ****

*The national subsidy for deliveries and emergency obstetric care in Burkina
Faso*

http://bit.ly/zZTP8w ****

*Abolition of user fees: the Uganda paradox*

http://bit.ly/xKDwF3 ****

*Can innovative health financing policies increase access to MDG-related
services? Evidence from Rwanda*

http://bit.ly/zvlY74 ****

*The sudden removal of user fees: the perspective of a frontline manager in
Burundi*

http://bit.ly/yY6Y50 ****

*Abolishing user fees for children and pregnant women trebled uptake of
malaria-related interventions in Kangaba, Mali*

http://bit.ly/wgAYgw ****

*The national free delivery policy in Nepal: early evidence of its effects
on health facilities*

http://bit.ly/AfxyHx ****

*Removing user fees for basic health services: a pilot study and national
roll-out in Afghanistan*

http://bit.ly/xzW0Ye ****

*Removing user fees: learning from international experience to support the
process*

http://bit.ly/xhTE2W

****
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