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Health care financing in Kenya: A simulation of welfare effects of user fees

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  • Mwabu, Germano M.
  • Mwangi, Wilfred M.

Abstract

This paper examines the efficiency and equity effects of introducing user fees in public health facilities in Kenya. These effects are studied with the aid of a simulation technique. It is found that through their favourable effects on quality of medical services, the user fees in public clinics would yield welfare gains. However, these gains might involve unacceptable equity trade-offs. Thus, in general, the net welfare effects of user charges on medical services is ambiguous. More specifically, if the user fees were imposed across the board in government health facilities, the equity trade-offs would be large, and for that reason, the user fees would be socially and politically unacceptable. But, if the user charges are restricted to government hospitals, the attendant equity problem would not be too difficult to manage.

Suggested Citation

  • Mwabu, Germano M. & Mwangi, Wilfred M., 1986. "Health care financing in Kenya: A simulation of welfare effects of user fees," Social Science & Medicine, Elsevier, vol. 22(7), pages 763-767, January.
    • Handle: RePEc:eee:socmed:v:22:y:1986:i:7:p:763-767
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    Cited by:

    1. Leonard, Kenneth L, 2007. "Learning in Health Care: Evidence of Learning about Clinician Quality in Tanzania," Economic Development and Cultural Change, University of Chicago Press, vol. 55(3), pages 531-555, April.
    2. Dow, W.H., 1995. "Welfare Impacts of Health Case User Fees : A Health- Valuation Approach to Analysis with Imperfect Markets," Papers 95-21, RAND - Labor and Population Program.
    3. Ardeshir Sepehri & Robert Chernomas, 2001. "Are user charges efficiency- and equity-enhancing? A critical review of economic literature with particular reference to experience from developing countries," Journal of International Development, John Wiley & Sons, Ltd., vol. 13(2), pages 183-209.
    4. Bolduc, Denis & Lacroix, Guy & Muller, Christophe, 1996. "The choice of medical providers in rural Benin: A comparison of discrete choice models," Journal of Health Economics, Elsevier, vol. 15(4), pages 477-498, August.
    5. Miloud Kaddar & Friedeger Stierle & Bergis Schmidt-Ehry & Anastase Tchicaya, 2000. "L'accès des indigents aux soins de santé en Afrique subsaharienne," Revue Tiers Monde, Programme National Persée, vol. 41(164), pages 903-925.
    6. Ana Revenga & Mead Over & Emiko Masaki & Wiwat Peerapatanapokin & Julian Gold & Viroj Tangcharoensathien & Sombat Thanprasertsuk, 2006. "The Economics of Effective AIDS Treatment : Evaluating Policy Options for Thailand," World Bank Publications - Books, The World Bank Group, number 7196, December.
    7. Lloyd Amaghionyeodiwe, 2008. "Determinants of the choice of health care provider in Nigeria," Health Care Management Science, Springer, vol. 11(3), pages 215-227, September.
    8. John S. Akin & David K. Guilkey & Paul L. Hutchinson & Michael T. McIntosh, 1998. "Price elasticities of demand for curative health care with control for sample selectivity on endogenous illness: an analysis for Sri Lanka," Health Economics, John Wiley & Sons, Ltd., vol. 7(6), pages 509-531, September.
    9. Randall P. Ellis & D. Keith McInnes & Elizabeth H. Stephenson, 1994. "Inpatient and outpatient health care demand in Cairo, Egypt," Health Economics, John Wiley & Sons, Ltd., vol. 3(3), pages 183-200, May.
    10. Nahu, Asteraye, 2006. "Determinants of demand for health care services and their implication on Health care financing: the case of Bure town," Ethiopian Journal of Economics, Ethiopian Economics Association, vol. 11(1), pages 122-122, April.

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