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Public Service Provision, User Fees, and Political Turmoil

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  • Marcel Fafchamps
  • Bart Minten

Abstract

Following an electoral dispute, the central highlands of the island of Madagascar were subjected to an economic blockade during the Þrst half of 2002. After the blockade ended in June 2002, user fees for health services and school fees were progressively eliminated. This paper examines the provision of schooling and health services to rural areas of Madagascar before, during, and after the blockade. We Þnd that public services were more resilient to the blockade than initially anticipated, but that health services were more affected than schools. The removal of user fees had a large significant effect on public services that is distinct from the end of the blockade and the increase in school book provision.

Suggested Citation

  • Marcel Fafchamps & Bart Minten, 2003. "Public Service Provision, User Fees, and Political Turmoil," CSAE Working Paper Series 2003-15, Centre for the Study of African Economies, University of Oxford.
    • Handle: RePEc:csa:wpaper:2003-15
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    Cited by:

    1. Christophe Nordman & Faly Rakotomanana & Anne-Sophie Robilliard, 2009. "Gender Disparities in the Malagasy Labour Market," Working Papers DT/2009/08, DIAL (Développement, Institutions et Mondialisation).
    2. Giovanni Andrea Cornia & Laura Deotti, 2008. "Millet Prices, Public Policy and Child Malnutrition: The case of Niger in 2005," Papers inwopa08/49, Innocenti Working Papers.
    3. Emanuela di Gropello, 2006. "Meeting the Challenges of Secondary Education in Latin America and East Asia : Improving Efficiency and Resource Mobilization," World Bank Publications - Books, The World Bank Group, number 7173.
    4. Lay, Jann, 2010. "MDG achievements, determinants and resource needs : what has been learnt ?," Policy Research Working Paper Series 5320, The World Bank.
    5. World Bank, 2012. "Madagascar - Three Years into the Crisis : An Assessment of Vulnerability and Social Policies and Prospects for the Future, Volume 1. Main Report [Madagascar après trois ans de crise : Evaluation d," World Bank Publications - Reports 12324, The World Bank Group.
    6. Anna S. Brink & Steven F. Koch, 2013. "The 1996 User Fee Abolition in South Africa: A Difference-in-Difference Analysis," Working Papers 201332, University of Pretoria, Department of Economics.
    7. Fafchamps, Marcel & Minten, Bart, 2006. "Crime, Transitory Poverty, and Isolation: Evidence from Madagascar," Economic Development and Cultural Change, University of Chicago Press, vol. 54(3), pages 579-603, April.
    8. Maryanne Sharp & Ioana Kruse, 2011. "Health, Nutrition, and Population in Madagascar 2000-09," World Bank Publications - Books, The World Bank Group, number 5957.
    9. Valéry Ridde & Seni Kouanda & Aristide Bado & Nicole Bado & Slim Haddad, 2012. "Reducing the Medical Cost of Deliveries in Burkina Faso Is Good for Everyone, Including the Poor," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-8, March.
    10. Ridde, Valéry & Diarra, Aïssa & Moha, Mahaman, 2011. "User fees abolition policy in Niger: Comparing the under five years exemption implementation in two districts," Health Policy, Elsevier, vol. 99(3), pages 219-225, March.
    11. Lépine, A. & Lagarde, M. & Le Nestour, A., 2015. "Free primary care in Zambia: an impact evaluation using a pooled synthetic control method," Health, Econometrics and Data Group (HEDG) Working Papers 15/20, HEDG, c/o Department of Economics, University of York.
    12. Raphaël Cottin, 2018. "Free health care for the poor: a good way to achieve universal health coverage? Evidence from Morocco," Working Papers DT/2018/16, DIAL (Développement, Institutions et Mondialisation).
    13. Takondwa Mwase, 2021. "Health financing policy reforms for universal health coverage in eastern, central and southern Africa (ECSA)-health community region," Working Papers 179cherp, Centre for Health Economics, University of York.

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    More about this item

    JEL classification:

    • O - Economic Development, Innovation, Technological Change, and Growth
    • P - Political Economy and Comparative Economic Systems

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