A new report by Save the Children UK looks at 24 countries in Africa, of which 20 impose charges for health services, and calls on G8 leaders to take action to make healthcare free for all.

Making healthcare free could save the lives of a quarter of a million African children every year.

Fees were widely introduced in the 1990s when international donors encouraged national governments to charge payments for healthcare. But these charges are prohibitively high for most poor families.

More than one in six children in sub-Saharan Africa die before their fifth birthday. Nearly two-thirds of these children die unnecessarily of diseases that can be prevented or treated easily: diarrhoea with oral rehydration salts, pneumonia with antibiotics, malaria with anti-malarials and measles with a one-shot vaccine.

Where fees are charged:

Over 50 per cent of people surveyed in Tanzania did not seek healthcare when they were chronically ill, and three quarters gave cost as the reason.

In Ethiopia, most people did not go to a health worker when ill. Of those who did, two-thirds deepened their poverty by selling assets, borrowing money or mortgaging their crops.

Where fees have been abolished:

In Uganda, fees were abolished in 2001 and spending on the health service was increased. As a result, outpatient attendance and the use of immunisation services both doubled.

In South Africa in 1998 all public primary care services became free at the point of use. A later national evaluation showed increases in use of health services of between 20 and 60 per cent.

Download the report - Killer Bills
[Adobe PDF, 88 Kb]