Removal of user fees for universal health coverage in Africa

3ie has awarded a proposal preparation grant to Population Council to prepare an impact evaluation proposal for measuring the impact of removal of user fees on universal health coverage in eastern, central and southern Africa region.

The policy intervention of removal of user fees is being implemented by the East, Central and Southern Africa Health Community (ECSA-HC) in several countries in the region.

The impact evaluation proposal will be prepared in the next three months. It will be reviewed and scored by at least one internal and three external reviewers. If the proposal is accepted, 3ie will award the research team a grant to conduct the impact evaluation under 3ie’s standard terms and conditions.

3ie had issued a request for qualifications from researchers for the preparation of this impact evaluation proposal. The call closed on 14 November 2013.

For more information on this call, please download the Request for Qualifications (261.9 KB)


The ESCA-HC is an intergovernmental body that was established in 1974 and is made up of 10 member states (Kenya, Lesotho, Malawi, Mauritius, Seychelles, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe). Over the past 10 years in the ECSA region, several countries have introduced a policy on removal of user fees, mainly to increase access to basic healthcare services especially by the poor and consequently contribute to achieving universal health coverage. However, evidence from some countries shows that the removal of user fees has been fraught with many challenges.

The objective of this study will be to evaluate the extent to which this policy on removal of user fees has contributed to universal health coverage in the ECSA region. The evaluation will examine this question in two to three countries.

At a glance

  • The request for qualifications closed on 14 November 2013.
  • Only institutions could apply for this grant. Individuals were not eligible.
  • The lead institution making the application had to be located in eastern, central or southern Africa, with national researchers as the lead Principal Investigator.
  • This was a request for qualifications of a team that is interested in preparing the evaluation design.
  • The proposed budget should not have exceeded $25,000 for the proposal preparation costs.
  • The qualifications will be reviewed and scored by at least one internal reviewer, one external reviewer, and one representative of the implementing agency.

3ie’s Policy Window

The Policy Window Two grants programme is designed to fund impact evaluations that are commissioned by the policymakers and programme managers who implement development interventions.

For more information, please visit the Policy Window page.

Photo © Lindsay Mgbor/DFID

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