background access to appropriate and affordable healthcare is needed to achieve better health outcomes in africa. however, access to healthcare remains low, especially among the poor. in zambia, poor access exists despite the policy by the government to remove user fees in all primary healthcare facilities in the public sector. the paper has two main objectives: (i) to examine the factors assoc...

BACKGROUND User fees have generally fallen out of favor across Africa, and they have been associated with reductions in access to healthcare. We examined the effects of the introduction and removal of user fees on outpatient attendances and new diagnoses of HIV, malaria, and tuberculosis in Neno District, Malawi where user fees were re-instated at three of 13 health centres in 2013 and subseque...

although globalization has created ample opportunities and spaces to share experiences and information, the diffusion of ideas, especially in global health, is primarily influenced by the unequal distribution of economic, political and scientific powers around the world. these ideas in global health are generally rooted in high-income countries (hics), and then reach low- and middle-income coun...

Background Access to appropriate and affordable healthcare is needed to achieve better health outcomes in Africa. However, access to healthcare remains low, especially among the poor. In Zambia, poor access exists despite the policy by the government to remove user fees in all primary healthcare facilities in the public sector. The paper has two main objectives: (i) to examine the factors assoc...

BACKGROUND Out-of-pocket payments in health care have been shown to impose significant burden on households in Sub-Saharan Africa, leading to constrained access to health care and impoverishment. In an effort to reduce the financial burden imposed on households by user fees, some countries in Sub-Saharan Africa have abolished user fees in the health sector. Zambia is one of few countries in Sub...

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 lowincome countries, recent years have seen growing criticism of the impact of fees on access to health services, particularly for the poorest groups. The ...

About 20 years after initial calls for the introduction of user fees in health systems in sub-Saharan Africa, a growing coalition is advocating for their removal. Several African countries have abolished user fees for health care for some or all of their citizens. However, fee-for-service health care delivery remains a primary health care funding model in many countries in sub-Saharan Africa. A...

BACKGROUND User fees for primary care tend to suppress utilization, and many countries are experimenting with fee removal. Studies show that additional inputs are needed after removing fees, although well-documented experiences are lacking. This study presents data on the effects of fee removal on facility quality and utilization in Afghanistan, based on a pilot experiment and subsequent nation...