摘要:Annotation This report describes and evaluates the ways in which user-fees are currently implemented to finance public health services in Sub- Saharan Africa. It presents the main issues that arise in assessing cost recovery through user fees and evaluates experiences to date. The authors highlight variety of practices encountered in different countries, the too common failure to structure charges so as to promote efficient use, and the lack of effective exemption structures for protecting the poor. The study thoroughly reviews standard cost recovery models and describes an initiative launched in Bamako, Mali, in 1987. Issues, experience, and conclusions are drawn from a sample of 38 countries.