REDUCTION OF USER FEES IN THE PRIVATE-NOT-FOR-PROFITHOSPITALS IN UGANDA: IMPLICATIONS FOR EQUITY ANDSUSTAINABILITY

While the reduction of user fees was not seriously contested as a bigstep towards equity and evidence of faithfulness to their mission, manyprivate-not-for-profit (PNFP) hospitals dragged their feet inimplementing these reductions, especially where the fees constituted abig proportion of their income. There were fears of diminishing revenuefrom fees, increasing expenditure on drugs and sundries, unreliabilityof government funding, fluctuation of income from other unreliablesources and serious threats to sustainability. With empirical evidencefrom 4 PNFP hospitals, this article demonstrates that where feesconstituted a barrier to access, there is likelihood for the over allrevenue from fees to increase after their reduction because ofincreased patient numbers. It will also be shown that recurrentexpenditure on consumables may not increase above the level of revenuefrom fees where there is prudent management. Henceforth, it will beargued that reduction of user fees does not compromise financialsustainability and health equity but rather promotes them both.