Do exemptions from user fees mean free access to health services? A case study from a rural Cambodian hospital

Tropical Medicine and International Health

Volumn 12, Issue 11, 2007, Pages 1391-1401

  Jacobs, Bart ^a,b   Price, Neil Lewis ^b   Oeun, Sam ^a  

^a Swiss Red Cross ^*  (Cambodia)

^b SWANSEA UNIVERSITY   (United Kingdom)

Author keywords

Cambodia; Economic burden; User fee exemption; User fee schemes

Indexed keywords

ASSESSMENT METHOD; HEALTH CARE; HEALTH EXPENDITURE; HEALTH SERVICES; HOSPITAL SECTOR; QUESTIONNAIRE SURVEY; RURAL AREA; USER FEE;

ADULT; ARTICLE; CAMBODIAN; CASE STUDY; COMPARATIVE STUDY; CONTROLLED STUDY; COPING BEHAVIOR; FEE; FEMALE; GROUPS BY AGE; HEALTH BEHAVIOR; HEALTH CARE; HEALTH CARE COST; HEALTH CARE FACILITY; HEALTH CARE PERSONNEL; HEALTH SERVICE; HOSPITAL; HOSPITALIZATION; HUMAN; INTERVENTION STUDY; MALE; POPULATION; PUBLIC HEALTH; REIMBURSEMENT; RURAL AREA; STRUCTURED QUESTIONNAIRE; UNSTRUCTURED INTERVIEW;

ADOLESCENT; ADULT; CAMBODIA; DELIVERY OF HEALTH CARE; FEES AND CHARGES; FEMALE; HEALTH EXPENDITURES; HEALTH SERVICES ACCESSIBILITY; HEALTH SERVICES RESEARCH; HOSPITALS, RURAL; HUMANS; MALE; MIDDLE AGED; PATIENT ACCEPTANCE OF HEALTH CARE; QUESTIONNAIRES;

ASIA; CAMBODIA; EURASIA; SOUTHEAST ASIA;

EID: 36648998947     PISSN: 13602276     EISSN: 13653156     Source Type: Journal    
DOI: 10.1111/j.1365-3156.2007.01926.x     Document Type: Article

References (49)

1. Abdu Z, Mohammed Z, Bashier I Eriksson B (2004) The impact of user fee exemption on service use and treatment seeking behaviour: the case of malaria in Sudan. International Journal of Health Planning and Management 19, S95 S106.
2. Ahmed SM, Adams AM, Chowdhury M Bhuiya A (2003) Changing health seeking behaviour in Matlab, Bangladesh: do development interventions matter? Health Policy and Planning 18, 306 315.
3. Ahmed SM, Petzold M, Kabir ZN Tomson G (2006) Targeted interventions for the ultra poor in rural Bangladesh: does it make any difference in their health seeking behaviour? Social Science and Medicine 63, 2899 2911.
4. Akashi H, Yamada T, Eng H, Koum J Sugimoto T (2004) User fees at a public hospital in Cambodia: effects on hospital performance and provider attitudes. Social Science and Medicine 58, 553 564.
5. Barber S, Bonnet F Bekedam H (2004) Formalizing under-the-table payments to control out-of-pocket hospital expenditures in Cambodia. Health Policy and Planning 19, 199 208.
6. Beaglehole R, Bonita R Kjellström T (1993) Basic Epidemiology. World Health Organization, Geneva.
7. Bossyns P Van Lerberghe W (2004) The weakest link: competence and prestige as constraints to referral by isolated nurses in rural Niger. Human Resources for Health, 2 [ http://www.human-resources-health.com/contect/2/1/1 ].
8. Creese AL (1991) User charges for health care: a review of recent experiences. Health Policy and Planning 6, 309 319.
9. Dalton A Peacock S (2005) Study of the Link between Health and Poverty. World Health Organization, Phnom Penh.
10. Daru P, Churchill C Beemsterboer E (2005) The prevention of debt bondage with microfinance-led services. European Journal of Development Research 17, 132 154.
11. Fabricant S, Camara CW Mills A (1999) Why the poor pay more: household expenditures in rural Sierra Leone. International Journal of Health Planning and Management 14, 179 199.
12. Filmer D (2005) Fever and its treatment among the more and less poor in sub-Saharan Africa. Health Policy and Planning 20, 337 346.
13. Gilson L, Russell S Buse K (1995) The political economy of user fees with targeting: developing equitable health financing policy. Journal of International Development 7, 369 402.
14. Gorman S, Pon D Sok K (1999) Gender and Development in Cambodia: An Overview. Cambodia Development Resource Institute, Phnom Penh.
15. Gruen R Howarth A (2005) Financial Management in Health Services. Open University Press, Berkshire.
16. Hardeman W, Van Damme W, Van Pelt M, Ir P, Heng K Meessen B (2004) Access to health care for all? User fees plus a health equity fund in Sotnikum, Cambodia. Health Policy and Planning 19, 22 32.
17. Huber JC (1993) Ensuring access to health care with the introduction of user fees: a Kenyan example. Social Science and Medicine 36, 485 494.
18. Jacobs B Price N (2004) The impact of the introduction of user fees at a district hospital in Cambodia. Health Policy and Planning 19, 310 321.
19. Jacobs B Price N (2006) Improving access for the poorest to public health services: insights from Kirivong Operational Health District in Cambodia. Health Policy and Planning 21, 27 39.
20. Jacobs B, Price N Sam OS (2007) A sustainability assessment of a health equity fund initiative in Cambodia. International Journal of Health Planning and Management 22, 183 203.
21. James CD, Hanson K, McPake B et al. (2006) To retain or remove user fees?: reflections on the current debate in low- and middle-income countries. Applied Health Economics and Health Policy 5, 137 153.
22. Kenyiro Y (2005) Why illness causes more serious damage than crop failure in rural Cambodia. Development and Change 36, 759 783.
23. Kivumbi GW Kintu F (2002) Exemptions and waivers from cost sharing: ineffective safety nets in decentralized districts in Uganda. Health Policy and Planning 17 (Suppl. 1 64 71.
24. Krishna A (2004) Escaping poverty and becoming poor: who gains, who loses, and why. World Development 32, 121 136.
25. Mandl PE Ofosu-Amaah S (1988) Community financing experiences for local health services in Africa. UNICEF Staff Working Papers No. 2, New York.
26. Mbugua JK, Bloom GH Segall MM (1995) Impact of user charges on vulnerable groups: the case of Kibwezi in rural Kenya. Social Science and Medicine 41, 829 835.
27. McIntyre D, Gilson L Mutyambizi V (2005) Promoting Equitable Health Care Financing in the African Context: Current Challenges and Future Prospects. EQUINET Discussion Paper (27).
28. McIntyre D, Thiede M, Dahlgren G Whitehead M (2006) What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts? Social Science Medicine 62, 858 865.
29. Meessen B, Van Damme W, Tashobya CK Tibouti A (2006) Poverty and user fees for public health care in low-income countries: lessons form Uganda and Cambodia. Lancet 368, 2253 2257.
30. Meng Q, Sun Q Hearst N (2002) Hospital charge exemptions for the poor in Shandong, China. Health Policy and Planning 17 (Suppl. 1 56 63.
31. Mills A (1991) Exempting the poor: the experience of Thailand. Social Science and Medicine 33, 1241 1252.
32. Ministry of Health, Cambodia (1997) National Charter on Health Financing in the Kingdom of Cambodia. Ministry of Health, Phnom Penh.
33. Ministry of Health, Cambodia (2005) Implementation and Monitoring Framework for the Equity Funds in Cambodia. Operational Manual. Ministry of Health, Phnom Penh.
34. Ministry of Planning, Cambodia (2000) Poverty Profile of Cambodia - 1999. Ministry of Planning, Phnom Penh.
35. Noirhomme M, Meessen B, Griffiths F et al. (2007) Improving access to hospital care for the poor: comparative analysis of four health equity funds in Cambodia. Health Policy and Planning 22, 246 262.
36. Pearson M (2004) Issue Paper: The Case for Abolition of User Fees for Primary Health Services. DFID Health Systems Resource Centre, London.
37. Price NL (2002) Service Sustainability Strategies in Sexual and Reproductive Health Programming. John Snow International, London.
38. Russell S Gilson L (1997) User fee policies to promote health service access for the poor: a wolf in sheep's clothing? International Journal Health Services 27, 359 379.
39. Russell S Gilson L (2006) Are health services protecting the livelihoods of the urban poor in Sri Lanka? Findings from two low-income areas of Colombo. Social Science and Medicine 63, 1732 1744.
40. Sepheri A Chernomas R (2001) Are user charges efficiency- and equity-enhancing? A critical review of economic literature with particular reference to experience from developing countries. Journal of International Development 13, 183 209.
41. Shaw RP Griffin C (1995) Financing Health Care in Sub-Saharan Africa through User Fees and Insurance. World Bank, Washington DC.
42. Thomas S, Killingsworth JR Acharya S (1998) User fees, self-selection and the poor in Bangladesh. Health Policy and Planning 13, 50 58.
43. Van Damme W, Van Leemput L, Ir P, Hardeman W Meessen B (2004) Out-of-pocket expenditure and debt in poor households: evidence from Cambodia. Tropical Medicine and International Health 9, 273 280.
44. Vong S, Perz JF, Sok S et al. (2005) Rapid assessment of injection practices in Cambodia, 2002. BMC Public Health 5, 56 [ http://www.biomedcentral. com/1471-2458/5/56 ].
45. Whitehead M, Dahlgren G Evans T (2001) Equity and health sector reforms: can low income countries escape the medical poverty trap? Lancet 358, 833 836.
46. Wilkinson D, Holloway J Fallavier P (2001) The Impact of User Fees on Access, Equity and Health Provider Practices in Cambodia. Ministry of Health/World Health Organization, Phnom Penh.
47. Willis CY Leighton C (1995) Protecting the poor under cost-recovery: the role of means testing. Health Policy and Planning 10, 241 256.
48. World Health Organization (2000) Women of South-East Asia: A Health Profile. World Health Organization, Regional Office for South-East Asia, New Delhi.
49. Worrall E, Basu S Hanson K (2005) Is malaria a disease of poverty? A review of the literature. Tropical Medicine and International Health 10, 1047 1059.