From: <b class="gmail_sendername">Ruggiero, Mrs. Ana Lucia (WDC)</b> <span dir="ltr"><<a href="mailto:ruglucia@paho.org">ruglucia@paho.org</a>></span><br><div class="gmail_quote">crossposted from : <a href="mailto:EQUIDAD@listserv.paho.org">EQUIDAD@listserv.paho.org</a><br>
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<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;line-height:normal;background:white"><b><font color="maroon" face="Arial" size="3"><span style="font-size:12.0pt;font-family:Arial;color:maroon;font-weight:bold" lang="EN-GB">User fee removal in the health
sector in low-income countries: <br>
</span></font></b><b><font color="maroon" face="Arial" size="3"><span style="font-size:12.0pt;font-family:Arial;color:maroon;font-weight:bold" lang="EN-GB">lessons
from recent national initiatives<br>
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</span></font></b><b><font color="maroon" face="Arial" size="3"><span style="font-size:12.0pt;font-family:Arial;color:maroon;font-weight:bold" lang="EN-GB"><u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in;background:white"><font color="black" face="Arial"><span style="line-height:115%;font-size:10.0pt;font-family:Arial" lang="EN-GB">Edited by Bruno Meessen, Lucy Gilson and
Abdelmajid Tibouti<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in;background:white"><b><font color="black" face="Arial"><span style="line-height:115%;font-size:10.0pt;font-family:Arial;font-weight:bold" lang="EN-GB">Health Policy and Planning
- Volume 26, Supplement 2 - November 2011<br>
<br>
<u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in;background:white"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB">Available free online at: <a href="http://bit.ly/zTUg1n" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/zTUg1n</span></font></a>
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<br>
<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in;background:white"><b><i><font color="black" face="Arial"><span style="line-height:115%;font-style:italic;font-size:10.0pt;font-family:Arial;font-weight:bold" lang="EN-GB">This supplement, sponsored by Unicef</span></font></i></b><font color="black" face="Arial"><span style="line-height:115%;font-size:10.0pt;font-family:Arial" lang="EN-GB">, focuses on the challenges related to the
design and implementation of user fee removal policies in low-income countries.<br>
<br>
</span></font><font color="black" face="Arial"><span style="line-height:115%;font-size:10.0pt;font-family:Arial" lang="EN-GB"><u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in;background:white"><font color="black" face="Arial"><span style="line-height:115%;font-size:10.0pt;font-family:Arial" lang="EN-GB">"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..... <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in;background:white"><font color="black" face="Arial"><span style="line-height:115%;font-size:10.0pt;font-family:Arial" lang="EN-GB">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 <b><i><span style="font-weight:bold;font-style:italic">UNICEF
and the research team led by the <u></u>Institute<u></u>
of <u></u>Tropical Medicine<u></u>, <u></u><u></u>Antwerp<u></u><u></u></span></i></b>: 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. <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in;background:white"><font color="black" face="Arial"><span style="line-height:115%;font-size:10.0pt;font-family:Arial" lang="EN-GB">This focus was seen as valuable because it
could generate practical lessons for other countries interested in such a step....
</span></font><font color="black" face="Arial"><span style="line-height:115%;font-size:10.0pt;font-family:Arial" lang="EN-GB">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.</span></font><font color="black" face="Arial"><span style="line-height:115%;font-size:10.0pt;font-family:Arial" lang="EN-GB">...<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in;background:white"><font color="black" face="Arial"><span style="line-height:115%;font-size:10.0pt;font-family:Arial" lang="EN-GB">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...."<br>
<br>
<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in;background:white"><b><font color="maroon" face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial;color:maroon;font-weight:bold" lang="EN-GB">The full supplement is
available free online:<br>
Volume 26 suppl 2 November 2011<br>
<br>
<u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;background:white"><b><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial;font-weight:bold" lang="EN-GB">User fee removal in low-income countries: <br>
sharing knowledge to support managed implementation</span></font></b><b><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial;font-weight:bold" lang="EN-GB"> </span></font></b><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB">[Editorial].<br>
<br>
<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;background:white"><font face="Arial" size="1"><span style="font-size:8.0pt;line-height:115%;font-family:Arial" lang="EN-GB">Bruno Meessen 1,*, Lucy Gilson 2,3 and Abdelmajid Tibouti 4<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;background:white"><font face="Arial" size="1"><span style="font-size:8.0pt;line-height:115%;font-family:Arial" lang="EN-GB">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 <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in;background:white"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB"><a href="http://bit.ly/ytNMUA" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/ytNMUA</span></font></a> <br>
<br>
<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-left:.5in;background:white"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB">“………..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 (</span></font><font face="Arial" size="1"><span style="font-size:7.0pt;line-height:115%;font-family:Arial" lang="EN-GB">Meessen et al. 2011).</span></font><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB">
Countries should also better share lessons of experience and good practices.
There is, therefore, a need for much better collective learning……….”<br>
<br>
<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;background:white"><b><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial;font-weight:bold" lang="EN-GB">Removing user fees for health services in
low-income countries: a multi-country review framework for assessing the
process of policy change<u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in;background:white"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB"><a href="http://bit.ly/xV1J1H" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/xV1J1H</span></font></a> <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;background:white"><b><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial;font-weight:bold" lang="EN-GB">Removing user fees in the health sector: a
review of policy processes in six <font color="maroon"><span style="color:maroon">sub-Saharan
African</span></font> countries<u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in;background:white"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB"><a href="http://bit.ly/wsVwkl" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/wsVwkl</span></font></a> <u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt"><b><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial;font-weight:bold" lang="EN-GB">The national subsidy for deliveries and emergency obstetric
care in <font color="maroon"><span style="color:maroon">Burkina Faso</span></font><u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB"><a href="http://bit.ly/zZTP8w" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/zZTP8w</span></font></a>
<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;line-height:normal;background:white"><b><font face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold" lang="EN-GB">Abolition of user fees: the <u></u><u></u><font color="maroon"><span style="color:maroon">Uganda</span></font><u></u><u></u>
paradox<u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB"><a href="http://bit.ly/xKDwF3" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/xKDwF3</span></font></a>
<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;line-height:normal;background:white"><b><font face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold" lang="EN-GB">Can innovative health financing policies increase access to
MDG-related services? Evidence from <u></u><u></u><font color="maroon"><span style="color:maroon">Rwanda</span></font><u></u><u></u><font color="maroon"><span style="color:maroon"><u></u><u></u></span></font></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB"><a href="http://bit.ly/zvlY74" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/zvlY74</span></font></a>
<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;line-height:normal;background:white"><b><font face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold" lang="EN-GB">The sudden removal of user fees: the perspective of a
frontline manager in <font color="maroon"><span style="color:maroon">Burundi</span></font><u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB"><a href="http://bit.ly/yY6Y50" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/yY6Y50</span></font></a>
<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;line-height:normal;background:white"><b><font face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold" lang="EN-GB">Abolishing user fees for children and pregnant women trebled
uptake of malaria-related interventions in <u></u><u></u>Kangaba<u></u>, <u></u><font color="maroon"><span style="color:maroon">Mali</span></font><u></u><u></u><u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB"><a href="http://bit.ly/wgAYgw" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/wgAYgw</span></font></a>
<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;line-height:normal;background:white"><b><font face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold" lang="EN-GB">The national free delivery policy in <u></u><u></u><font color="maroon"><span style="color:maroon">Nepal</span></font><u></u><u></u>:
early evidence of its effects on health facilities<u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB"><a href="http://bit.ly/AfxyHx" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/AfxyHx</span></font></a>
<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;line-height:normal;background:white"><b><font face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold" lang="EN-GB">Removing user fees for basic health services: a pilot study
and national roll-out in <u></u><u></u><font color="maroon"><span style="color:maroon">Afghanistan</span></font><u></u><u></u><u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB"><a href="http://bit.ly/xzW0Ye" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/xzW0Ye</span></font></a>
<u></u><u></u></span></font></p>
<p class="MsoNormal" style="margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;line-height:normal;background:white"><b><font face="Arial"><span style="font-size:10.0pt;font-family:Arial;font-weight:bold" lang="EN-GB">Removing user fees: learning from international experience to
support the process<u></u><u></u></span></font></b></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB"><a href="http://bit.ly/xhTE2W" target="_blank"><font color="black"><span style="color:windowtext">http://bit.ly/xhTE2W</span></font></a><font color="black"><span style> <br>
<br>
<u></u><u></u></span></font></span></font></p>
<p class="MsoNormal" style="margin-left:.5in"><font face="Arial"><span style="font-size:10.0pt;line-height:115%;font-family:Arial" lang="EN-GB"></span></font><br></p></div></div></div><br>