Understanding the impact of user fees on gender in Tanzania
In 1993 the government of Tanzania introduced user fees in health care services. The poor, children under five, Maternal and Child Health/Family Planning and maternity services are among the groups exempted from fees. However, it is observed that the fee exemption system in public health facilites is not functioning. According to the media and gender activists, the introduction of user fees in primary health care services was reported to have impacted negatively on vulnerable groups, particularly poor women. This study aims at exploring how user fees for health care impacted on poor Tanzanian women. In order to have a clear understanding of the issues, the study establishes the impact of user fees on poor women as perceived by poor women in urban and rural areas, and by key stakeholders involved in user fee policy development. Further, the study looks at efforts made by diferent stakeholders to take into account a gender perspective in the design and implementation of the policy. Finally, the study examines whether the policy process took into consideration the potential negative effects on poor women after its implementation.
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