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Economic and Welfare Effects of the Abolition of Health User Fees : Evidence from Uganda

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  • Deininger, Klaus
  • Mpuga, Paul

Abstract

The authors use household level data for Uganda for 1999-2000 and 2002-03, before and after the abolition of user fees for public health services, to explore the effect of this policy on different groups'ability to access health services and morbidity outcomes. They find that the policy change improved access and reduced the probability of sickness in a way that was particularly beneficial to the poor. Although the challenge of maintaining service quality remains, aggregate benefits are estimated to be significantly larger than the estimated shortfalls from the abolition of user fees.

Suggested Citation

  • Deininger, Klaus & Mpuga, Paul, 2004. "Economic and Welfare Effects of the Abolition of Health User Fees : Evidence from Uganda," Policy Research Working Paper Series 3276, The World Bank.
    • Handle: RePEc:wbk:wbrwps:3276
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    References listed on IDEAS

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    1. Deininger, Klaus & Mpuga, Paul, 2005. "Does Greater Accountability Improve the Quality of Public Service Delivery? Evidence from Uganda," World Development, Elsevier, vol. 33(1), pages 171-191, January.
    2. Xu, Ke & Evans, David B. & Kadama, Patrick & Nabyonga, Juliet & Ogwal, Peter Ogwang & Nabukhonzo, Pamela & Aguilar, Ana Mylena, 2006. "Understanding the impact of eliminating user fees: Utilization and catastrophic health expenditures in Uganda," Social Science & Medicine, Elsevier, vol. 62(4), pages 866-876, February.
    3. Aoife Brick & Anne Nolan & Jacqueline O’Reilly & Samantha Smith, 2012. "Conflicting Financial Incentives in the Irish Health-Care System," The Economic and Social Review, Economic and Social Studies, vol. 43(2), pages 273-301.
    4. Nolan, Anne & Smith, Samantha, 2012. "The effect of differential eligibility for free GP services on GP utilisation in Ireland," Social Science & Medicine, Elsevier, vol. 74(10), pages 1644-1651.
    5. Tankari, Mahamadou & Badiane, Ousmane & Montaud, Jean-Marc, 2013. "When social goals meet economic goals: the double dividend of extending access to healthcare for farmers in Uganda," Conference papers 332430, Purdue University, Center for Global Trade Analysis, Global Trade Analysis Project.
    6. Valéry Ridde & Seni Kouanda & Aristide Bado & Nicole Bado & Slim Haddad, 2012. "Reducing the Medical Cost of Deliveries in Burkina Faso Is Good for Everyone, Including the Poor," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-8, March.
    7. Jean-Marc Montaud & Mahamadou Roufahi Tankari, 2013. "When social goals meet economic goals: the double dividend of extending free access to healthcare in Uganda," Working Papers hal-01880339, HAL.
    8. Zombré, David & De Allegri, Manuela & Ridde, Valéry, 2017. "Immediate and sustained effects of user fee exemption on healthcare utilization among children under five in Burkina Faso: A controlled interrupted time-series analysis," Social Science & Medicine, Elsevier, vol. 179(C), pages 27-35.
    9. Giovanni Andrea Cornia & Laura Deotti, 2008. "Millet Prices, Public Policy and Child Malnutrition: The case of Niger in 2005," Papers inwopa08/49, Innocenti Working Papers.
    10. Ensor, Tim & Ronoh, Jeptepkeny, 2005. "Effective financing of maternal health services: A review of the literature," Health Policy, Elsevier, vol. 75(1), pages 49-58, December.
    11. Hamadou Daouda, Youssoufou, 2011. "Déterminants de la mortalité infantile et infanto-juvénile et la pauvreté au Niger [Determinants of infant and under-five mortality and poverty in Niger]," MPRA Paper 73154, University Library of Munich, Germany.
    12. Johnson, Ari & Goss, Adeline & Beckerman, Jessica & Castro, Arachu, 2012. "Hidden costs: The direct and indirect impact of user fees on access to malaria treatment and primary care in Mali," Social Science & Medicine, Elsevier, vol. 75(10), pages 1786-1792.
    13. Shinsuke Tanaka, 2008. "Access to Health Infrastructure and Child Health Development: Evidence from Post-Apartheid South Africa," ISER Discussion Paper 0768, Institute of Social and Economic Research, Osaka University, revised Jan 2010.
    14. Hadley, Mary, 2011. "Does increase in utilisation rates alone indicate the success of a user fee removal policy? A qualitative case study from Zambia," Health Policy, Elsevier, vol. 103(2), pages 244-254.

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