Charging households for drugs and services in government health centres and retaining the fees for improving that service, also giving local householders a strong voice in the operation of the facility.
About half of Guinea's 350 health centres were practising community financing in 1991. Of these, all the urban-based facilities and a third of the rural clinics were able to cover their operating expenses with income from fees.
Community financing of health centres is a virtuous necessity because it can help to improve the quality and reliability of services, in part by making health workers more accountable to their clientele.
Fees substantial enough to cover the full cost of clinical services can discourage utilization by the poor.