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Ensuring equal access to health services : user fee systems and the poor

Author: William C Newbrander; David Collins; Lucy Gilson
Publisher: Boston : Management Sciences for Health, ©2000.
Edition/Format:   Print book : EnglishView all editions and formats
Summary:
Health programs in which patients pay fees for services generate much-needed revenue but also raise important concerns: Can the poor gain access to health services when fees are charged? How can health programs ensure that people receive services based on need rather than ability to pay? Some countries have developed mechanisms to protect the poor from the negative effects of user charges; do these protections  Read more...
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Document Type: Book
All Authors / Contributors: William C Newbrander; David Collins; Lucy Gilson
ISBN: 9780913723791 0913723797
OCLC Number: 45283214
Description: xi, 187 pages : illustrations ; 23 cm
Contents: Figures --
Tables --
Acknowledgments --
Part One: Background, Concepts, and Issues --
Introduction to Equity in User Fee Systems --
Key Concepts and Issues --
Part Two: Methodology and Country Studies --
Methodology for the Country Studies --
Equity in Kenya --
Equity in Guinea --
Equity in Tanzania --
Equity in Ecuador --
Equity in Indonesia --
Part Three: Findings, Policy Options, and Management Guidelines --
Synthesis of the Findings: What Happened to the Poor? --
The Policy Options --
Implementation and Management Guidelines --
Conclusion: The Past and Future of User Fees and Equity --
Glossary --
Bibliography --
About the Authors --
Index.
Responsibility: William Newbrander, David Collins, Lucy Gilson.

Abstract:

Health programs in which patients pay fees for services generate much-needed revenue but also raise important concerns: Can the poor gain access to health services when fees are charged? How can health programs ensure that people receive services based on need rather than ability to pay? Some countries have developed mechanisms to protect the poor from the negative effects of user charges; do these protections mechanisms work? This book examines user fee systems in five countries (Kenya, Guinea, Tanzania, Ecuador, and Indonesia) to answer these questions and make recommendations for policy experts and decision-makers. In many instances, user fees have reduced the access of the poor to health services, often because exemption mechanisms are poorly designed or implemented. In other cases, fees have improved access to services and quality of care. The book synthesizes these lessons and identifies issues that must be addressed to protect the poor.

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