Ministry of Health user fees, equity and decentralization: lessons from Honduras

Ministry of Health user fees, equity and decentralization: lessons from Honduras.

Decentralization is commonly championed as a means for achieving equity. To date, however, there has been little discussion of the mechanisms underlying this relationship, and several of the few empirical investigations that have addressed the topic have found the converse; that decentralization has exacerbated inequalities. This article examines the performance and equity in financing of the H...

Access to health care for all? User fees plus a Health Equity Fund in Sotnikum, Cambodia.

User fees in health services are a source of much debate because of their potential risk of negative effects on access to health care for the poor. A Health Equity Fund that identifies the poor and pays on their behalf may be an alternative to generally ineffective fee exemption policies. This paper presents the experience of such a Health Equity Fund, managed by a local non-governmental organi...

Global Health Systems: Pricing and User Fees

This chapter is concerned with the issue of user fees (or user charges) for public health services. We discuss the implications of user fees for cost-e¤ectiveness, allocative e¢ ciency, equity, progressivity of public health care spending, and quality of service. Each of these is a desirable end in itself, and so each is an important factor in the optimal pricing decision. They are not always c...

User fees or equity funds in low-income countries.

Decentralization in health care: lessons from public economics

One of the central interests of modern public finance theory is the implication of decentralization for the equity and efficiency of public services. It is therefore somewhat surprising that health policy in the UK and elsewhere is formulated with hardly any reference to this theory and the associated empirical evidence. The purpose of this paper is to examine the relevance of mainstream public...