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Removing user fees is an effective strategy in increasing people’s access to healthcare. It can make an important contribution to getting the Millennium Development Goals on child and maternal health back on track. Using evidence from Uganda and other countries, Freeing up Healthcare sets out the five key steps policy-makers and technical staff should take to remove fees for essential healthcare.The guide explains how to: • analyse your starting position • estimate how removing fees will affect service utilisation • estimate additional human resource and drug requirements • mobilise additional funding • communicate the policy change. Freeing up Healthcare is a technical guide but it also summarises the key economic and political arguments for removing user fees. It demonstrates that political commitment and effective communication are key ingredients of a successful policy change. “ … a policy change to remove user fees will not, in itself, improve people’s access to healthcare – the policy needs to be implemented successfully to have a real impact on people’s health… You are likely to achieve the greatest impact where the whole process – from early planning to implementation – is backed by political commitment and good communication.” Freeing up Healthcare A guide to removing user fees Freeing up H ealthcare A guide to rem oving user fees C