Does User Fee Removal Policy Provide Financial Protection from Catastrophic Health Care Payments? Evidence from Zambia

PloS One
Felix MasiyeJoses M Kirigia

Abstract

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-Saharan Africa to abolish user fees in primary health care facilities with a view to alleviating financial burden of out-of-pocket payments among the poor. The main aim of this paper was to examine the extent and patterns of financial protection from fees following the decision to abolish user fees in public primary health facilities. Our analysis is based on a nationally representative health expenditure and utilization survey conducted in 2014. We calculated the incidence and intensity of catastrophic health expenditure based on households' out-of-pocket payments during a visit as a percentage of total household consumption expenditure. We further show the intensity of the problem of catastrophic health expenditure (CHE) experienced by households. Our analysis show that following the removal of user fees, a majority of patients who visited public...Continue Reading

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Feb 9, 2017·International Journal for Equity in Health·Edwine W BarasaNirmala Ravishankar
Oct 17, 2017·Health Economics·Aurélia LépineAlexis Le Nestour
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Jan 27, 2021·International Journal of Environmental Research and Public Health·Samuel López-LópezFrancisco Escribano-Sotos

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