Table 9. Effects of reducing user fees on health service utilization in low- and middle-income countries, according to literature review.
| Study | Outcome measure | Percent variation in fee | Reanalysis for the systematic review |
Conclusions presented in the original study | ||||
|---|---|---|---|---|---|---|---|---|
| Percent change in intervention area(s)a | “Absolute” elasticitya | Percent change in control area(s) | Percent change in intervention areas | “Relative” elasticity | ||||
| Abdu et al. (2004)31 | Number of children seen in health centres for malaria | –25 | +63.6*** | –2.5 | +31 | +32.6 | –1.3 | Increase in use of services; lesser increase in facilities offering 50% exemption perhaps due to lack of health personnel |
| –50 | +32.3*** | –0.6 | +31 | +1.3 | –0.02 | |||
| –75 | +280.4*** | –3.7 | +31 | +249.4 | –3.3 | |||
| Number of pregnant women seen in health centres for malaria | –25 | +52.1*** | –2.1 | +6.2 | +45.9 | –1.8 | ||
| –50 | +27.9*** | –0.6 | +6.2 | +21.7 | –0.43 | |||
| –75 | +131.4*** | –1.7 | +6.2 | +125.2 | –1.7 | |||
| Ojeda et al. 199428 | Number of monthly new IUD usersb | –25 | +254.8*** | –10.2 | +72.6 | +182.2 | –7.3 | Increase in the number of users |
| –50 | +287.3*** | –5.7 | +72.6 | +214.7 | –4.3 | |||
| –25 | +236.5*** | –9.5 | +30.8 | +205.7 | –8.2 | |||
| –50 | +241.2*** | –4.8 | +30.8 | +210.5 | –4.2 | |||
Significance levels (computed for the review when possible): ***P < 0.001. IUD, intrauterine device. a In the original paper by Abdu et al.,31 this is defined as the “correlation coefficient between the level of exemption and relative increase of cases of malaria seen”. b The first two rows compare changes between the period September 1991–February 1992 and September 1992–February 1993, while the last two compare the periods of March–August 1992 and March–August 1993.