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user fees

Financial incentives in health: supply- vs. demand-side. Your help is needed!

Adam Wagstaff's picture

A blogpost on financial incentives in health by one of us in September 2015 generated considerable interest. The post raised several issues, one being whether demand-side financial incentives (like maternal vouchers) are more or less effective at increasing the uptake of key maternal and child health (MCH) interventions than supply-side financial incentives (variously called pay-for-performance (P4P) or performance-based financing (PBF)).

The four of us are now hard at work investigating this question — and related ones — in a much more systematic fashion. And we'd very much welcome your help.

User fees and abuser fees

Shanta Devarajan's picture

If user fees for health have been so vilified (including in comments on this blog), why are we bringing the subject up again?  Because new evidence calls into question the prevailing view, namely that removing user fees leads to: (i) increased use of health services and hence to (ii) improved health outcomes.  Confirming (i), the recent literature shows that (ii) does not always follow.

Principles

Raising the price of a good or service has two effects: it reduces demand and increases supply.  In the case of user fees for health, it was thought that paying for a service also makes people use it more appropriately (you don’t go to the doctor for minor ailments) and value it more than if they obtained it for free.