The elimination of user fees in Uganda - World Health Organization

determinant of catastrophic expenditure for the poor observed in the regressions was theuse of private facilities.The abolition of user fees did, therefore, seem to have a beneficial effect in that itencouraged more poor people to seek care at public facilities when they were ill. Thisreduced one important barrier to care. It did not, however, reduce the proportion of poorhouseholds that subsequently faced catastrophic health expenditures. Poor households inUganda, as in many African countries, still face difficult choices - seeking care when theyare ill will improve their health, but the act of seeking care can result in financialcatastrophe. This is a key challenge for policy makers over the next decade. At presentlarge quantities of external funds for health are flowing into many African countrieswhich enables services to be heavily subsidized. However, the challenge will be to buildsustainable financing systems which reduce barriers to access care while at the same timeprotecting people against the financial risks of accessing care.