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Bulletin of the World Health Organization - Modelling the Effectiveness of Financing Policies to Address Underutilization of Children’s Health Services in Nepal
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Reference: Pokhrel, Subhash; Hidayat, Budi; Flessa, Steffen; Sauerborn, Rainer (2002). Bulletin of the World Health Organization - Modelling the Effectiveness of Financing Policies to Address Underutilization of Children’s Health Services in Nepal, WHO. URL-http://apps.who.int/iris/ Several studies have assessed the effect of user fees on
the utilization of health-care services (for example in Peru (8), Burkina Faso (9) and in the Philippines (10)). These studies are reviewed by Gertler & Hammer (11). These studies have consistently shown that user fees have significant effects on utilization, in particular among low-income groups. In the countries studied, health care at government facilities was free until user fees were introduced. In Nepal, user fees have long prevailed in different forms (e.g., charges for registration, investigations or drugs). We wondered whether price was the major determinant of the low level of utilization in Nepal. Few attempts have been made to explore the extent to which the price of health care
affects the demand for it in Nepal. A study that used data from 1984 found that cost was the most significant determinant of the choice of provider and that the impact of cost on choice is greater for poorer people, women and children (12). Another study that analysed health expenditure showed that income (as an indicator of ability to pay for care) has both a direct effect on health expenditure and an indirect effect through the likelihood of becoming ill and the type of provider chosen (4). While both of these studies shed light on the effect of price, they reveal little about whether demand would be responsive to an increase or decrease in the price of health care. This paper attempts to answer two questions. The first is: to what extent can financial subsidies increase the utilization of formal health-care services in Nepal? The second question is: does an increase in user fees lead to an increase in total revenue? We focus on the utilization of health-care services for children because illness such as diarrhoea and acute respiratory tract infections are the leading causes of mortality among children in Nepal. These causes can largely be avoided by the timely and appropriate use of formal health-care services.

WHO ,   (2005 )
Type / Script:
Bulletin or Poster in English
Thematic Group:
 WHO : World Health Organization
10.02.00  -  Comprehensive Health Services
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