Hidden costs: The direct and indirect impact of user fees on access to malaria treatment and primary care in Mali

by Ari Johnson, Adeline Goss, Jessica Beckerman et al.
Social Science and Medicine, Volume 75, Issue 10, November 2012, pp. 1786-1792

7 pp. 167 kB:
http://www.malarianexus.com/_common/updateable/files/articles/634838365629112622.pdf

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. Although the impact of user fees on utilization of health services and household finances has been studied extensively, further research is needed to characterize the multi-faceted health and social problems associated with charging user fees.

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