Table 1 Changes in user fee policy during the 1990s, Zimbabwe

Early 1991

Enforcement of user fee collection at all health facilities at the start of ESAP

November 1992

User fee exemption level raised from ZWD 150 to ZWD 400

January 1993

Temporary abolition of fees at rural health centres because of the drought

June 1993

Reinstitution of user fees at rural health centres

January 1994

Substantial increase in user fees at all health institutions

March 1995

Abolition of user fees at rural health centres and rural hospitals

October 1996

Increase in user fees at all referral hospitals: services at rural hospitals and health centres remain free of charge

January 1997

Start of the Health Services fund; retention of user fee revenues at the district and facility level: reinstitution of user fees at (some) rural mission hospitals

1998

No more health grants for the municipalities; higher than average increase in user fees

November 1999

Substantial increase in user fees at government health institutions