IMFIN brief 8: Household out-of-pocket payments

Why are out-of-pocket payments so strongly discouraged for immunization services? What kinds of informal fees persist in some countries today?

Key points

• User fees for immunization services create a barrier to access, especially for poor people, thus jeopardizing the public health goal of achieving high rates of coverage.
• Officially sanctioned user payments for immunization are now uncommon, but informal charges still occur in some countries. For example, households may be forced to buy injection supplies, such as syringes, out of pocket when a public facility runs out.
• Best practices include centralized procurement of injection supplies and ensuring that vaccines are bundled with injection devices in the supply chain.