Navigation Links
Free health care: Yes, but with caution

ANTWERP Over the last years, many low and middle-income countries have removed user fees in their health care sector. Researchers from Africa, Asia, Northern America and Europe have studied these policies; their findings are gathered in a supplement of the scientific journal Health Policy & Planning, coordinated by Bruno Meesen from the Antwerp Institute of Tropical medicine. Experiences from Afghanistan, Burundi, Burkina Faso, Mali, Nepal , Rwanda and Uganda, among others, are documented in this supplement. Conclusion: it is possible, but should not be done ill-advised.

The main lessons from their analyses are the following ones:

  • These policies are often decisions taken by the highest country authorities; sometimes during electoral campaigns
  • Many countries are opting for selective free health care (e.g. free health care for children under 5, free delivery). This allows a good alignment on the Millennium Development Goals and is probably reasonable, given the costs of free health care policies.
  • When these decisions are taken in a hasty manner without sufficient consultation of stakeholders (including technicians working for the concerned ministries), health systems may experience a shock (difficulty to cope with the increase in patients; drug shortages).
  • When these policies are well-designed, implemented with the appropriate accompanying measures and sufficiently funded, they can improve access to health services. Insufficient funding may however imply that the increased utilisation by the population paradoxically leads households to spend more for their treatment (for instance, because of drug shortages in free public health facilities, households may have to buy their drugs in private pharmacies).
  • There are different ways to reduce financial barriers to health care; free health care is an option, health insurance is another. Any good solution for the vulnerable populations and the public budget will require a certain level of complexity. It is therefore important that leaders consult their technicians; the latter can help the former to build fair, efficient and sustainable health care systems.
  • Donors, aid agencies and Northern Non-Governmental Organizations have a role to play, but in full respect of sovereign choices made by low-income countries.

According to Bruno Meessen, researcher at the Institute of Tropical Medicine and coordinator of the supplement, "Leadership developed by African leaders in favour of vulnerable populations such as young children and pregnant women has to be praised. Good outcomes for these groups however require a long term commitment in terms of public resources and policies which are sound from a technical perspective. Providing free health care is more complex than it is usually thought."

Lucy Gilson, Professor at the London School of Hygiene & Tropical Medicine and at the University of Cape Town and co-editor of the supplement says: "As leaders take important decisions to strengthen health systems for the benefit of the poorest, their engagement with communities, health workers and technicians is vital in bringing those decisions alive in the day to day practice of health care delivery".

Abdelmajid Tibouti of UNICEF New York "hopes that this supplement sponsored by UNICEF will be a source of inspiration for governments and their partners. Equity is a major challenge in many countries. Technical and financial partners have probably a stronger support role to play, in full respect of course of options chosen by countries themselves. A first track is to network countries implementing similar policies."

In this respect, Bruno Meessen sees very positive trends. "African experts working on these issues are organised themselves in a community of practice. Thanks to information & communication technology, they constantly share their experience and knowledge. Opportunities to learn from each other are many."

Contact: Bruno Meesen
Institute of Tropical Medicine Antwerp

Related medicine news :

1. Carolinas HealthCare System Volunteers to Join Navy Rescue Mission in Haiti
2. SXC Health Solutions to Host Fiscal 2009 Fourth Quarter and Year End Results Conference Call
3. A New Website Series Improves Appearance and Health City by City
4. Diet-to-Go Welcomes 2 Key Philadelphia Fitness Centers as Partners-in-Health
5. Quantum Health Appoints Stark as Executive Vice President of Sales
6. New Report: The Internet Has More Influence Over Consumer Health Actions than Traditional DTC Channels
7. Satellite Healthcares Sheila Doss Elected Western Chapters Coordinator-Elect of the American Nephrology Nurses Association
8. Changing the Course of Kids Health
9. Mental Health America Encourages Journalists, Media Professionals to Submit Entries for 2010 Media Awards
10. Idaho House Moves State Closer to Health Care Disaster
11. UNT Health Science Centers Roby Helps Identify Bodies of Chiles Patio 29
Post Your Comments:
(Date:11/28/2015)... ... 2015 , ... Beginning November 30th at 6:00 a.m. EST until 11:59 p.m. EST, ... savings of up to 20% off orders $80 or more to free gifts with purchases, ... hours. , As a competitive e-commerce website for skin care and cosmetic needs, customers will ...
(Date:11/27/2015)... ... , ... According to an article published November 13th on, ... D.C. revolved around the fact that proper dental care, both at-home and in the ... between periodontal disease (more commonly referred to as gum disease) and diabetes. According to ...
(Date:11/27/2015)... ... 27, 2015 , ... The rapid speed at which Americans ... more care is needed, especially with Alzheimer’s, dementia and other cognitive conditions becoming ... The forgotten part of this equation: 80 percent of medical care occurs in ...
(Date:11/27/2015)... ... November 27, 2015 , ... "When ... said an inventor from Hillside, N.J. "Many people catch diseases simply from sitting ... individuals will always be protected from germs." , He developed the patent-pending QUDRATECS ...
(Date:11/27/2015)... ... November 27, 2015 , ... ProSidebar: Fashion is a set of ... With ProSidebar: Fasion, video editors can easily add an informative sidebar to any FCPX ... Utilize presets featuring self-animating drop zones, lines, bars, and text with the ease ...
Breaking Medicine News(10 mins):
(Date:11/29/2015)... Royal Philips  (NYSE: PHG, AEX: PHIA) revealed a portfolio ... Society of North America Annual Meeting (RSNA), beginning today ... Chicago . Visitors to the Philips booth ... integrated Diagnostic Imaging, Clinical Informatics, Image Guided Therapy and ... and create a superior patient experience. ...
(Date:11/27/2015)... Une nouvelle approche consistant ... contre le cancer avancé.    --> ... au traitement photodynamique au Bremachlorin contre le cancer ... nouvelle approche consistant à combiner l,immunothérapie au traitement ...    Clinical Cancer Research . ...
(Date:11/27/2015)... Nov. 26, 2015 ... of the "2016 Global Tumor Marker ... Volume and Sales Segment Forecasts, Innovative Technologies, ... report to their offering. --> ... the "2016 Global Tumor Marker Testing ...
Breaking Medicine Technology: