Where should I include user fees paid to public facilities?
What people pay at public facilities is part of household activity as a financing agent. Therefore, these copayments appear in the NHA as FS.2.2xHF2.3, not as FS.2.2xHF.1.1 or FS.2.2xHF.1.2 (see PG pages 36 and 42 and paragraph 10.15). User charges at government facilities definitely should be included in the accounts to the extent that they support and maintain health facilities or programmes. The question is which entity to credit as the financing agent. In many countries, user charges for health services delivered by publicly funded health facilities are retained by the facility concerned or considered part of that facility’s budget (for example, most cost recovery programmes implemented in Africa and in Latin America in the 1980s and 1990s). In other countries, the fees are returned to the central ministry and are included in that budget. Regardless of the arrangement, where the fees have been paid by consumers in return for delivery of services, the household is the appropriate fi
