Abolishing user charges presentation
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The document discusses the implications of abolishing user charges for healthcare, highlighting both advantages such as improved access and equity, and disadvantages like increased patient load and potential service quality issues. Key factors for effective implementation include clear communication, establishing local funds, and ensuring adequate resources. The document references various studies on the impacts of removing user fees in different regions.
Abolishing user charges presentation
- 2. Out of Pocket Expenditure âą Payments made by households at the point of receiving health services. âą Includes - Spending on alternative and/or traditional medicine but âą Excludes - Expenditure on transportation to obtain care and special nutrition.
- 3. Catastrophic Health Expenditure âą Capacity of a Household to pay for Health. âą Financial catastrophe when its total out-of-pocket health payments equal or exceed 40% of its non-subsistence expenditure.
- 5. Should User Charges be Abolished or Not ???
- 6. Advantages of Abolishing User Charges 1. Improved access to health care services 2. Decrease in out of pocket payments 3. Increased equity by ensuring financial protection of the poor
- 7. Disadvantages of Abolishing User Charges 1. Increase in coverage of Curative Services as compared to Preventive Services 2. Increase in Patient load (Congestion) 3. Poor provision of Quality of Services - Unavailability of Drugs 4. Overloaded Health workers 5. Delay in reimbursement 6. Disruption in HIS â Lack of adequate Healthcare workforce. 7. Does not bring much change in Service utilization. (Sweden) 8. Emergence of Dual System for Healthcare 9. Lack of clear governance and leadership
- 8. Plenary Discussion What are key factors in effective implementation of abolition of user charges from public health facilities?
- 9. Few Factors 1. Analysis of countryâs initial position 2. Specific government unit 3. Communicate clearly with health workers and managers 4. Establish new funds at local level, for small-scale spending decisions 5. Before the policy change, wide range of public information campaign 6. Adequate drugs and staff to be available 7. âClose to clientâ services 8. Establish monitoring systems
- 10. References 1. Wilkinson D, Gouws E, Sach M, Karim SS. Effect of removing user fees on attendance for curative and preventive primary health care services in rural South Africa. Bulletin of the World Health organization. 2001;79:665-71. 2. Xu K, Evans DB, Kadama P, Nabyonga J, Ogwal PO, Aguilar AM. The elimination of user fees in Uganda: impact on utilization and catastrophic health expenditures. WHO, Genf (http://www. who. int/health_financing/The% 20elimination% 20of% 20user% 20fees% 20in% 20Uganda% 20% 20DP. 05.4. pdf. 2005. 3. Ridde V, Robert E, Meessen B. A literature review of the disruptive effects of user fee exemption policies on health systems. BMC Public health. 2012 Dec;12(1):289. 4. Farrants K, Bambra C, Nylen L, Kasim A, Burström B, Hunter D. The recommodification of healthcare? A case study of user charges and inequalities in access to healthcare in Sweden 1980â2005. Health Policy. 2017 Jan 1;121(1):42-9. 5. LĂ©pine, A., Lagarde, M., & Le Nestour, A. (2018). How effective and fair is user fee removal? Evidence from Zambia using a pooled synthetic control. Health economics, 27(3), 493-508.