Poverty, User Charges, Healthcare Demand, Nigeria


Healthcare in Nigeria is paid for on a cash and carry basis while out-of-pocket expenses dominate in households’ payment for health care services as a result of user charges that were introduced in the early 1980s. This coupled with the persistent poverty level in Nigeria raises the question of consumers’ ability and willingness to pay these user charges. Accordingly, using primary data, this study examined the possible effect of these user charges on the demand for Public Health Care Services in Nigeria, especially how it affects the poor and low-income earners. The analysis showed that increasing user fees substantially reduced the use of government health facility especially by the poor and the low-income earners. Also, the poor are more likely to trade-off their utilization of public sector health care services for self-treatment or traditional healers, thus significantly lowering their utilization of any modern medical care. Thus, it was recommended, among others, that government should introduce price discrimination into user fees, to be set at marginal cost. This would help avoid the adverse distribution effects of user-fees, especially, on the lower income group.



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