Visit for the latest Coronavirus Disease (COVID-19) updates.

You are here

Evidence-Based Resource Summary

Strength of Evidence: 
4 out of 4
4 out of 4
Year Published: 

The Impact of User Fees on Access to Health Services in Low- and Middle-Income Countries

Description of Resource: 
This Cochrane systematic review assessed the effectiveness of introducing, removing, or changing user fees to improve access to health care in low-and middle-income countries. It included 16 studies out of the 243 identified and found that when fees were introduced or increased, the use of health services decreased significantly in most studies. The review suggests that reducing or removing user fees increases the utilization of certain health care services.

Evidence-Based Resource Details

help Learn more about EBR criteria
Developed By: 
Cochrane Library
Developer Type: 
Non-Federal Government
Healthy People 2020 Topic Area(s): 
Access to Health Services
Healthy People 2020 Objectives: 
Resource Type: 
Systematic Review
Lagarde M, Palmer N. The impact of user fees on access to health services in low- and middle-income countries. Cochrane Database of Systematic Reviews 2011, Issue 4. Art. No.: CD009094. doi: 10.1002/14651858.CD009094. Available from: