On the allocation of revenues from user fees: The case of health budgeting in sub-Saharan Africa

Increasingly, Third World governments are instituting fees in previously free health care systems. The purpose is to generate revenues for additional health care and to increase utilization efficiency. The authors examine the following questions: How should fees be shared between hospitals and the health ministry to give hospitals optimal incentives? How can access for the poor be protected? How do we ensure that the additional revenues are allocated efficiently and equitably?