An analysis carried out by the Ministry of Health with 2017 data confirms that user fees are collected at public health units with a high administrative complexity: Funds are registered as revenue, so they have to be declared at a Provincial Tax Office, then to the Central Tax Authority, Treasury, and finally can return to the health unit after request, if proper justification is in place.
Budgetary relevance is very low: 0,26% of the total expenditure comes from user fees. This amount rises until 4% in hospitals, and 5% in Central Hospital of Maputo, and 5,76% in the new Provincial Hospital of Matola, near Maputo.
Important to say that a large ampount of user fees is used outside the national financial systems.
The analysis has had the support of the P4H Technical Assistant at the Ministry of Health. After the presentation and technical meetings, user fee policy will head to simplification, regulamentation, and study the possibility of abolishing user fees (at least the lower ones) and substituing for other more efficient pre-payment schemes.
