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dc.contributor.authorMcPake, Barbara
dc.contributor.authorBrikci, N.
dc.contributor.authorCometto, G.
dc.contributor.authorSchmidt, A.
dc.contributor.authorAraujo, Edson
dc.date.accessioned2018-06-29T22:03:31Z
dc.date.available2018-06-29T22:03:31Z
dc.date.issued2011-11
dc.identifierER2607
dc.identifier.citationMcPake, B., Brikci, N., Cometto, G., Schmidt, A. & Araujo, E. (2011) Removing user fees: Learning from international experience to support the process, Health policy and planning, vol. 26, , pp. ii104-ii117,
dc.identifier.issn0268-1080
dc.identifier.urihttp://dx.doi.org/10.1093/heapol/czr064
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/2607
dc.description.abstractRemoving user fees could improve service coverage and access, in particular among the poorest socio-economic groups, but quick action without prior preparation could lead to unintended effects, including quality deterioration and excessive demands on health workers. This paper illustrates the process needed to make a realistic forecast of the possible resource implications of a well-implemented user fee removal programme and proposes six steps for a successful policy change: (1) analysis of a country's initial position (including user fee level, effectiveness of exemption systems and impact of fee revenues at facility level); (2) estimation of the impact of user fee removal on service utilization; (3) estimation of the additional requirements for human resources, drugs and other inputs, and corresponding financial requirements; (4) mobilization of additional resources (both domestic and external) and development of locally-tailored strategies to compensate for the revenue gap and costs associated with increased utilization; (5) building political commitment for the policy reform; (6) communicating the policy change to all stakeholders. The authors conclude that countries that intend to remove user fees can maximize benefits and avoid potential pitfalls through the utilization of the approach and tools described.
dc.format.extentii104-ii117
dc.publisherOxford University Press
dc.relation.ispartofHealth policy and planning
dc.titleRemoving user fees: Learning from international experience to support the process
dc.typearticle
dcterms.accessRightsrestricted
dc.description.facultysch_iih
dc.description.volume26
dc.identifier.doihttp://10.1093/heapol/czr064
dc.description.ispublishedpub
dc.description.eprintid2607
rioxxterms.typearticle
qmu.authorAraujo, Edson
qmu.authorMcPake, Barbara
dc.description.statuspub
dc.description.numberSupple


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