Freeing up Healthcare: A guide to removing user fees

Sets out the five key steps policy-makers and technical staff should take to remove fees for essential healthcare

Published: October 2008

Removing user fees is an effective strategy in increasing people’s access to healthcare. It can make an important contribution to getting the Millennium Development Goals on child and maternal health back on track.

Using evidence from Uganda and other countries, Freeing up Healthcare sets out the five key steps policy-makers and technical staff should take to remove fees for essential healthcare. The guide explains how to:

analyse your starting position
estimate how removing fees will affect service utilisation
estimate additional human resource and drug requirements
mobilise additional funding
communicate the policy change

Freeing up Healthcare is a technical guide but it also summarises the key economic and political arguments for removing user fees. It demonstrates that political commitment and effective communication are essential ingredients of a successful policy change.

“… a policy change to remove user fees will not, in itself, improve people’s access to healthcare — the policy needs to be implemented successfully to have a real impact on people’s health… You are likely to achieve the greatest impact where the whole process — from early planning to implementation — is backed by political commitment and good communication.”

Download Freeing up Healthcare (PDF 650KB)

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Freeing up Healthcare: A guide to removing user fees

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