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Cost Recovery in Public Health Services in Sub-Saharan Africa

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TLDR
The study consists of two parts: theoretical and conceptual models that might be employed to implement user charges; and a review of recent cost recovery experiences in Africa.
Abstract
Many developing countries are currently reforming their health care systems and are experimenting with various mechanisms for delivering and financing health care. One such mechanism has been the introduction of cost recovery for health services. As part of its training program for the health sector, EDI's Human Resources Development Division felt it would be useful to do a survey of cost recovery schemes, particularly in sub-Saharan Africa, and to analyze the objectives, processes, and results of different approaches. This book summarizes the findings of that study. It is designed mainly for health policymakers and senior health care managers in sub-Saharan Africa and will be used in EDI seminars on health financing and health sector reform in that region. The study consists of two parts: theoretical and conceptual models that might be employed to implement user charges; and a review of recent cost recovery experiences in Africa.

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Access to health care in developing countries: breaking down demand side barriers

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The Lessons of User Fee Experience in Africa

TL;DR: If introduced by themselves, fees are unlikely to achieve equity, efficiency or sustainability objectives and should, therefore, be seen as only one element in a broader health care financing package that should include some form of risk-sharing.
References
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Book

The willingness to pay for medical care : evidence from two developing countries

TL;DR: By analyzing the level of health care chosen in rural communities in Cote d'Ivoire and Peru, the authors conclude that demand is price sensitive and that children and the poor are hurt more by the introduction of user fees than is the population in general.
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Financing Health Services in Developing Countries: An Agenda for Reform

TL;DR: 4 policies for health financing are proposed to raise revenues for important health programs increase the efficiency of public health services and make the system better serve the poor.
Journal ArticleDOI

User fees plus quality equals improved access to health care: results of a field experiment in Cameroon.

TL;DR: This study found that probability of the poorest quintile seeking care increases at a rate proportionately greater than the rest of the population, since the poor are most responsive to price changes.
Journal ArticleDOI

Quality of Medical Care and Choice of Medical Treatment in Kenya An Empirical Analysis

TL;DR: It is found that broad availability of drugs in a medical facility is positively related to medical care use and that health care demand decreases with user fees and with greater distance to the provider, but increases with income.
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