Social financing and fee - for - service cost recovery in Niger -- phase 2 and 3 : field work, research results, and policy recommendations

A third district was used as a control. One method the project tested was a form of social financing (tax and fee), and the second method was a fee charged for each episode of illness. The results of the project test, which were to include data on revenue generation, quality of care, access, and management, were to help Nigerian policymakers decide which type of cost-recovery system to implement nationwide. This paper addresses the issue of access -- primarily, the effect of cost recovery on the use of health systems by vulnerable groups, including the poorest quartile and the elderly. In general, the social financing method was the preferred choice by an overwhelming majority of the respondents, preferred over both the current system, and the other proposed method of a fee per each episode of illness; both preventive and curative care was sought by a larger percentage of respondents in the social financing district than in the other two districts tested. (Author abstract)