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Extra resources for Financing health services through user fees and insurance: case studies from Sub-Saharan Africa
3 According to the Better Health in Africa study, about $1 per capita is sufficient to provide almost full coverage of essential drugs for primary health care. Summing up, time and experience are required to develop a well-functioning system of fees. Actual contributions of fees seldom reflect their potential because fee policies tend to be poorly administered, facilities often perform poorly in collecting unpaid bills, patients are unwilling to pay for low quality services, and abuse of exemption policies is widespread.
A crude illustration of the magnitudes involved can be derived from information contained in Better Health in Africa (World Bank 1994a). 70 per capita on health -- the majority on operating costs. One-half of this amount, on average, goes to operating public hospitals. 3 According to the Better Health in Africa study, about $1 per capita is sufficient to provide almost full coverage of essential drugs for primary health care. Summing up, time and experience are required to develop a well-functioning system of fees.
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