Killer Bills: Mahe Child Poverty History - abolish user fees

Summary: User fees for basic healthcare, paid in the
poorest countries around the world, are in
reality “killer bills”. Children and their families
either don’t go to the health clinic when they
are sick or when they do, and have to pay,
they are forced further into poverty and
sometimes have to go without food. Some
families remove children from school in order
to pay for health care.

A quarter of a million African children's lives could be saved each year by a
simple step by the G8

Making healthcare free could save the lives of a quarter of a million African
children every year, reveals a new report published today by Save the
Children UK. Launched on the International Day of the African Child, the
report - "Killer Bills" - looks at 24 countries in Africa, of which 20 impose
charges for health services, and calls on G8 leaders to take action to make
healthcare free for all.

Fees were widely introduced in the 1990s when international donors
including the G8 encouraged national governments to charge payments for
healthcare. But these charges are prohibitively high for most poor families.
In Tanzania, for example, typical charges range from the equivalent of 30p
for registration on each visit to health centres and rise substantially to
nearly £10 for hospital treatment. This cost means that families either don't
seek treatment or wait until it is too late to go to the doctor.

More than one in six children in sub-Saharan Africa die before their fifth
birthday. Nearly two thirds of these die unnecessarily of diseases that can
be prevented or treated easily: diarrhoea with oral rehydration salts,
pneumonia with antibiotics, malaria with anti-malarials and measles with a
one shot vaccine.

Where fees are charged:
- Over 50 per cent of people surveyed in Tanzania did not seek healthcare
when they were chronically ill, and three quarters gave cost as the reason.
- In Ethiopia, most people did not go to a health worker when ill. Of those
who did, two-thirds deepened their poverty by selling assets, borrowing
money or mortgaging their crops.

Where fees have been abolished:
- In Uganda, fees were abolished in 2001 and spending on the health
service was increased. As a result, outpatient attendance and the use of
immunisation services both doubled.
- In South Africa in 1998 all public primary care services became free at the
point of use. A later national evaluation showed increases in use of health
services of between 20 and 60 per cent.

Mike Aaronson, Director General of Save the Children UK, said:
“2005 must be the breakthrough year to make child poverty history. With
the G8 Summit less than three weeks away, it is time that world leaders
took action to double aid so that all children can get healthcare. It is
children who will pay the price if the G8 leaders fail.

Children are dying every day of preventable illnesses like pneumonia and
diarrhoea because their families cannot afford fees imposed under
pressure from international donors, including the G8. World leaders must
address this and ensure that these killer bills are abolished.”

Abolishing fees and increasing aid for health are important first steps in
improving health services in poor countries. Abolishing fees would be
relatively inexpensive. Recent research by the Millennium Project*** has
revealed an $18 billion shortfall for health systems. Of this figure, less than
6 per cent would need to be spent in order to abolish fees in the 20
countries in Africa.

Save the Children is calling for the following recommendations:
- The UK Government should take a lead by clarifying its own position on
user fees and using its presidencies of the G8 and EU to influence other
rich governments
- G8 countries to provide more aid for healthcare in poor countries and to
couple this with long-term investment in health systems
- International donors to stop encouraging the imposition of user fees

-Ends-
pdf: www.savethechildren.org.uk/scuk_cache/scuk/cache/cmsattach/2966_Killer%2...

Organisation: 
Web: 
http://www.savethechildren.org.uk/scuk/jsp/resources/details.jsp?id=2872&group=resources&section=news&subsection=details

Countries

Please note that these reports are hosted by CRIN as a resource for Child Rights campaigners, researchers and other interested parties. Unless otherwise stated, they are not the work of CRIN and their inclusion in our database does not necessarily signify endorsement or agreement with their content by CRIN.