Economic and structural factors
Gender dimensions of user fees: implications for women’s utilization of health care
User fees prevent many poor women from accessing health services in Africa
Authors:
P. Nanda
Publisher:
Reproductive Health Matters , 2002
This article, published in Reproductive Health Matters, looks at the implications of user fees for women’s utilisation of health care services in Africa. The article shows that a lack of access to resources and inequitable decision-making power means that many poor women are put out of reach of health care when they face out-of-pocket costs such as user fees. The fact that user fees may be low does not preclude other informal or hidden costs that women experience, which together can add up to amounts beyond their means. The trade-offs that women may make in order to pay for health care can lead to debt, use of ineffective treatments of neglect of their health and other needs.
The paper concludes that in order to mitigate the negative effects of current policies on the health of poor women more efforts are required to examine the budgetary implications of user fees at the household level, the health consequences of delays in care seeking or recourse to affordable but ineffective care, and the tradeoffs that women make to pay for health care. Issues around women’s ability to pay are also pertinent to thinking about other methods of cost-recovery, including pre-payment schemes and health insurance mechanisms.
