Authors : 1Nahid Akhter Jahan , 2Rumana Huque and 2Iftekher Hossain
Abstract: The current policies of International Monetary Fund, World Bank and UNICEF favor the introduction of user fees in the health sector of developing countries as part of the health sector reform program. This paper is an attempt to examine the effects of introducing user fees on the health care service utilization in the public facilities, especially by the women, children and the poor in details using empirical analysis, and to deduce policy implications. For this purpose, this article draws on national and international experience with user fees. Available evidence suggests that the introduction of user charge had profound effect on the utilization of health care services in most of the developing countries, including Bangladesh. In Bangladesh, a drop in outpatient attendance was found where fee system was introduced, while there was an increase in the inpatient service utilization. Moreover, the drop in utilization disproportionately affected the women and the poor. Hence, much caution is required before introducing user fees at public facilities. The paper, therefore, proposes gradual implementation of user fees in varying degrees for various income groups. It is also essential to introduce safety nets for the poor to protect them from the adverse effects of user charges.
1Nahid Akhter Jahan , 2Rumana Huque and 2Iftekher Hossain , 2005. Effect of Introduction of User Charges on Health Care in the Public Facilities: Evidences from Some Selected Countries Including Bangladesh . Pakistan Journal of Social Sciences, 3: 260-268.