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Regional themes > Children and education Last update: 2020-11-27  

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Save the Children

Paying with their lives: The cost of illness for children in Africa

Regina Keith, Peter Shackleton

Save the Children UK


SARPN acknowledges Save the Children UK as a source of this publication:
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The lives of hundreds of thousands of children in Africa could be saved each year by abolishing fees for healthcare. What’s more, it would cost relatively little.

Save the Children UK estimates that the lives of 285,000 children in Africa could be saved every year by abolishing healthcare fees.Thousands more children would lead healthier lives without healthcare fees pushing their families into poverty.

Fees put basic healthcare treatment out of reach of poor people or force them into debt. In Sierra Leone a course of treatment for a child suffering from malaria costs 18,000 leones, or Ј4.24. It would take the average Sierra Leonean 14 days to earn this amount. In UK terms, it’s the equivalent of a British citizen paying Ј700 for treatment. Giving birth at a clinic costs around 55,000 leones (Ј13).That’s the equivalent of more than Ј2,200 in the UK.

For millions of people in countries in Africa, healthcare fees have failed to do the job they were intended to do.African governments have been encouraged by donors such as the World Bank to introduce fees for healthcare. It was hoped that charging fees would both help pay for health services and improve access to healthcare.

In reality, however, fees fund less than 5 per cent of what it costs countries in Africa to run public health services and there are high administrative costs.At the same time, when fees have been introduced, take-up of health services has dropped, typically by 40–50 per cent. Inevitably, it’s poor families who miss out.

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