The Impact Of User Fees On The Use Of Health Services In Zambia: A Gendered Look

Faced with budgetary constraints, rising population, external pressure, and deteriorating health services, the Zambian government through its Ministry of Health, embarked on a health reform programme with an effort of providing to the Zambians equity of access to cost-effective quality health care as close to the family as possible. Part of the health reforms has been the introduction of user fees on medical services. While others may argue that user fees can lead to an improvement of quality of care, efficiency and equity of access to health care, user fees can act as a disincentive to patients and can lead to some people not attending health facilities because they cannot afford. This paper focused on a gendered assessment of the impact of user fees on health facility use. The main arguments were that the introduction of user fees has resulted in the decline of use of health facilities and that userfees are more likely to affect women than men.