This report, one of a series of five regional thematic reports, analyses the financial barriers of access that limit use of essential health services by the poor, examines the composition of health financing, and weighs up the pros and cons of alternative approaches to social protection for health in the region. The report focuses in particular on the impact of user fees and the prerequisites for successful user fee abolition, while also assessing other approaches to equitable health financing such as social health insurance and mutual health organizations.