User fees in health services in Nigeria: The health policy implications

Abstract

There is widespread implementation of formal or informal user fees for health care in Nigeria. Quantitative and qualitative survey was conducted in various parts of eastern Nigeria to assess the impression of the Nigeria general public on the institution or abolition of user fees in health services. Of the total of 910 study participants, 520(57.1%) supported the institution of user fees while 390(42.9%) supported the abolition. Majority of study participants would prefer paying user fees if they are affordable and would guarantee efficient and quality service. The greater percentage of those advocating for abolition of user fees were the non-literate persons, the unemployed and the aged. If user fees are to be instituted, there is need for a mechanism that will provide some concessions such as appropriate systems of waivers and exemptions to these categories of individuals, so that no one is denied assess to basic health care.