Assessment of User Fees and Indirect Costs for People Seeking HIV Services in Nigeria

HP+ assessed the prevalence, magnitude, and types of direct user fees and indirect costs incurred by people living with HIV in select states in Nigeria: Akwa Ibom, Kano, Lagos, and Rivers. The study found that 25 percent of patients surveyed reported paying at least one direct user fee for HIV care services during their last visit to a healthcare facility. The average amount spent on user fees was NGN 1,235, (US$3.40), equivalent to almost one full day of income for all patients sampled. Indirect costs included an average of NGN 619 (US$1.70) on transportation, and 3.9 hours in time expended in travel and receiving the service at the facility. Financial burden as a proportion of the average daily income represented by user fees and indirect costs was significant. The report details the costs for people seeking HIV services; the brief provides recommendations on how the government of Nigeria and other stakeholders can reduce and/or eliminate user fees for HIV service delivery in Nigeria, thus helping to increase people’s access to HIV care.

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