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Free primary care in Zambia: an impact evaluation using a pooled synthetic control method

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  • Lépine, A.
  • Lagarde, M.
  • Le Nestour, A.

Abstract

We estimate the impacts of user fee removal in Zambia using a pooled synthetic control method. We find no evidence that user fee removal changed health seeking behaviours, even among the poorest. We show that these results are not attributable to the imperfect implementation of the policy. Nonetheless, our results confirm that the policy virtually eliminated medical expenditures, thereby providing financial protection to health services users. Since the poorest individuals were found to be less likely to use care and had lower expenses, ceteris paribus, the policy effect was similar to a transfer of US$2.22 per medical visit for the total sample but of only US$0.65 for the poorest people.

Suggested Citation

  • 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.
    • Handle: RePEc:yor:hectdg:15/20
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    Cited by:

    1. Kaisa Alavuotunki, 2015. "General budget support, health expenditures, and neonatal mortality rate: A synthetic control approach," WIDER Working Paper Series wp-2015-108, World Institute for Development Economic Research (UNU-WIDER).
    2. Kaisa Alavuotunki, 2015. "General budget support, health expenditures, and neonatal mortality rate," WIDER Working Paper Series 108, World Institute for Development Economic Research (UNU-WIDER).
    3. Sven Neelsen & Owen O'Donnell, 2017. "Progressive universalism? The impact of targeted coverage on health care access and expenditures in Peru," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 179-203, December.

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    More about this item

    Keywords

    user fees; health care use; health expenditure; provider choice; synthetic control; propensity score matching; difference-in-differences; Zambia;
    All these keywords.

    JEL classification:

    • C01 - Mathematical and Quantitative Methods - - General - - - Econometrics
    • C20 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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