The protected coral reefs off the coast of Malaysia receive numerous tourists, while also being as fishing grounds. These joint environmental pressures raise the need for additional costly conservation measures. It is natural to consider the potential for expanding the 'user pays' principle, already implemented in the form of various user fees. This study explores the potential for price discri...

User fees for municipal services may generate revenue for municipalities and their utility commissions, but they are equally important as prices for those services. Pricing services at marginal cost can lead to efficient production and consumption of the service, and efficient allocation of the service when capacity limits are reached; and it can help to guide investment on an efficient basis. ...

A pilot eliminating user fees associated with delivery at the point of services was introduced in two districts of Laos in March 2009. Following two years of implementation, an evaluation was conducted to assess the pilot impact, as well as to document the pilot design and implementation challenges. Study results show that, even in the presence of the substantial access and cultural barriers, u...

With user fees now seen as a major hindrance to universal health coverage, many countries have introduced fee reduction or elimination policies, but there is growing evidence that adherence to reduced fees is often highly imperfect. In 2004, Kenya adopted a reduced and uniform user fee policy providing fee exemptions to many groups. We present data on user fee implementation, revenue and expend...

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...

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OBJECTIVE To estimate the impact on maternal and child mortality after eliminating user fees for pregnant women and for children less than five years of age in Burkina Faso. METHODS Two health districts in the Sahel region eliminated user fees for facility deliveries and curative consultations for children in September 2008. To compare health-care coverage before and after this change, we use...

This paper uses Uganda National Household Survey (UNHS) data to investigate, via a discrete choice model, the main determinants associated with seeking private, government and pharmacy based health care, for both adults and children. More specifically, and particularly important given that almost 40% of the Ugandan population are below the poverty line and that policies on user fees have recent...

Responding to budget shortages, many developing nations around the world have adopted formal or informal systems of user fees for health care in public hospitals and health centers. In most countries user fee proceeds represent a small share of total public health facility recurrent costs, but they tend to account for a significant proportion of the resources required to pay for non-personnel c...