User fee removal has been put forward as an approach to increasing priority health service utilization, reducing impoverishment, and ultimately reducing maternal and neonatal mortality. However, user fees are a source of facility revenue in many low-income countries, often used for purchasing drugs and supplies and paying incentives to health workers. This paper reviews evidence on the effects ...

In theory, the removal of user fees puts health services within reach of everyone, including the very poor. When Burkina Faso adopted the DOTS strategy for the control of tuberculosis, the intention was to provide free tuberculosis care. In 2007-2008, interviews were used to collect information from 242 smear-positive patients with pulmonary tuberculosis who were enrolled in the national tuberc...

In its 2008 annual report, the World Health Organization (WHO) urged countries to " resist the temptation to rely on user fees " [1, p. 26]. Indeed, the consensus in the scientific community is that user fees have harmful effects on health care use and household budgets, especially for the poorest [2]. Still, as the WHO observes, " …most of the world's health-care systems continue to rely on th...

This paper examines public support for new user fees established at the Desolation Wilderness in California as part of the Fee Demonstration Program. Traditional approaches to fee policy evaluations have typically focused on economic or revenue issues and equity impacts of various pricing strategies. Support for fees has been shown to vary by users in terms of attitudes toward fees, nature of u...