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Although user-fees were officially abolished in Uganda in 2001 [ 45], in practice some health facilities charge fees for delivery services.
Participants noted that some health facilities, the private-not-for-profit, charged fees for delivery services, and this affected the decision to deliver at those units.
One of FEMHealth's objectives was to improve the knowledge base regarding the effectiveness, cost and impact of the removal of user fees for delivery care by carrying out comprehensive evaluations.
Thus, the promise made by Burkina Faso's President in 2010 to abolish fees for delivery completely, an important step still waiting to be organized [ 55], could potentially further reduce home deliveries in the study area.
More recently, the government announced further changes, abolishing user fees for delivery care at all public health facilities while continuing to provide the SDIP's conditional cash transfer to women.
Another national policy issue cited by workers as unjust both from a distributive and procedural injustice perspective was the implementation of the fee free delivery policy, which involved universal exemptions from payment of user fees for delivery services (Ansong-Tornui et al. 2007).
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The regime currently operates a bloated, inefficient industrial sector to maintain employment, which is possible because the government derives most of its revenue from natural-resources trade (mainly refined Russian oil and domestic potash deposits) and transit fees for deliveries of Russian oil and natural gas to Europe.
Meanwhile, the fees for deliveries on Roadie are often more affordable than traditional shippers, with costs that range from $12 to $200 depending on the item's size and the distance traveled.
Increasing public funding and eliminating point-of-service user fees for deliveries also has an impact on women's autonomy.
Most studies reviewing utilisation following the removal of user fees for deliveries have found a rise in assisted deliveries and caesarean sections at health facilities [ 21, 24- 26] and, in some cases, found that gains are greater in poorer groups [ 27].
Except for some recent studies in Ghana and Senegal, where user fees for deliveries were abolished [ 17- 19], there is, as of yet, no evidence on this subject in West Africa, and particularly in countries that have organized their health care system on the basis of the Bamako Initiative (BI).
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