Topics in Middle Eastern and North African Economies
Document Type
Article
Publication Date
9-1-2021
Abstract
The effect of introducing or increasing user fees in low- and middle-income countries is controversial. While user fees are advocated as an effective means of generating revenue and enabling the quality improvement of health services, they are a financial barrier to access health services for the poorer. This paper contributes to the literature on the demand-side financing in health by providing evidence on the medium-term effects of introducing user fees on the utilization of family planning, antenatal and delivery care services, women’s access to health care, and child health status in a middle-income country setting. Using difference-indifferences models with fixed effects, we find that the introduction of user fees in Egypt had no significant negative effect on the utilization of family planning and delivery care services; did not hinder women’s access to care; and did not harm child health outcomes. Positive effects were even observed with respect to the utilization of antenatal care services. Our findings are compatible with the hypothesis that the potential decrease in demand due to the introduction of user fees might have been offset by an increased willingness to pay for a health care quality that could be, at least partly, just perceived as higher.
Journal Title
Topics in Middle Eastern and North African Economies
ISSN
2334-282X
Publisher
Middle East Economic Association and Loyola University Chicago
Volume
23
Issue
2
Recommended Citation
El-Shal, Amira; Cubi-Molla, Patricia; and Jofre-Bonet, Mireia, "Are User Fees in Health Care Always Evil? Evidence from Family Planning, Maternal, and Child Health Services". Topics in Middle Eastern and North African Economies, electronic journal, 23, 2, Middle East Economic Association and Loyola University Chicago, 2021, http://www.luc.edu/orgs/meea/
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Copyright Statement
© The Author(s), 2021
Comments
Presentation of the articles in the Topics in Middle Eastern and North African Economies was made possible by a limited license granted to Loyola University Chicago and Middle East Economics Association from the authors who have retained all copyrights in the articles.