Poverty, user charges and health care demand in Nigeria

Abstract

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 trade-off between user charges and demand for Public Health Care Services in Nigeria. The analysis showed that increasing user fees substantially reduced the use of government health facility by low-income earners. 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.