Removing health user fees needs planning

Several developing nations have removed healthcare user fees, but British researchers recommend carefully planning for the change. Bruno Meesen of the Antwerp Institute of Tropical medicine in Antwerp, Netherlands, coordinated the research of the removal of healthcare user fees in Afghanistan, Burundi, Burkina Faso, Mali, Nepal, Rwanda, Uganda and other countries. Meesen said the researchers found it is possible to remove healthcare user fees either by providing free health or providing health insurance -- but careful analysis and planning is needed to provide a smooth transition. The findings, published in a supplement of the journal Health Policy & Planning, include: -- Many countries opt for selective free healthcare such as for children age 5 or under or childbirth services. -- The decisions to remove barriers to healthcare are often taken in a hasty manner without sufficient consultation of stakeholders. -- When policies are well-designed, implemented with the appropriate measures and sufficiently funded, they can improve access to health services. But insufficient funding might result in families spending more for treatment, such as buying drugs in private pharmacies. -- Donors, aid agencies and non-governmental organizations have a role to play, but must respect sovereign choices made by poor countries.