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User charges for rural health services in Papua New Guinea

Author

Listed:
  • Thomason, Jane
  • Mulou, Navy
  • Bass, Caroline

Abstract

This paper reports on a review of user charges for health services in rural areas of Papua New Guinea. Facilities implementing both fee for service and community risk sharing schemes were studied. This study found that there is a lack of any policy framework or practical guidelines on cost recovery. In some areas fees are being used as a fiscal tool rather than to further health policy. This study from Papua New Guinea raises serious questions about the virtue of cost recovery for health services in rural areas. Equity is an issue and the fees are creating a barrier both for entry and continuation in the health system; accountability is poor, and issues of cross subsidization are not addressed; fee revenues from rural health services are small and primarily of local significance; and are not being used to improve quality of health services. Cost recovery schemes in rural areas have the potential to provide a valuable contributory source of income to operate and improve health services. In practice, few are achieving this. It is concluded that health sector financing focus could be more fruitfully directed to financing mechanisms with greater potential to improve and expand health services.

Suggested Citation

  • Thomason, Jane & Mulou, Navy & Bass, Caroline, 1994. "User charges for rural health services in Papua New Guinea," Social Science & Medicine, Elsevier, vol. 39(8), pages 1105-1115, October.
    • Handle: RePEc:eee:socmed:v:39:y:1994:i:8:p:1105-1115
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    Citations

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    Cited by:

    1. Andrew McNee, 2012. "Illuminating the local: can non-formal institutions be complementary to health system development in Papua New Guinea?," Development Policy Centre Discussion Papers 1215, Development Policy Centre, Crawford School of Public Policy, The Australian National University.
    2. Dow, W.H., 1995. "Welfare Impacts of Health Case User Fees : A Health- Valuation Approach to Analysis with Imperfect Markets," Papers 95-21, RAND - Labor and Population Program.
    3. Ardeshir Sepehri & Robert Chernomas, 2001. "Are user charges efficiency- and equity-enhancing? A critical review of economic literature with particular reference to experience from developing countries," Journal of International Development, John Wiley & Sons, Ltd., vol. 13(2), pages 183-209.
    4. Xu, Ke & Evans, David B. & Kadama, Patrick & Nabyonga, Juliet & Ogwal, Peter Ogwang & Nabukhonzo, Pamela & Aguilar, Ana Mylena, 2006. "Understanding the impact of eliminating user fees: Utilization and catastrophic health expenditures in Uganda," Social Science & Medicine, Elsevier, vol. 62(4), pages 866-876, February.

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