INTRODUCTION
STATEMENT OF THE PROBLEM
Equity may be defined as the requirement that individuals of unequal ability to pay make different payment (Vertical equity) or those of the same ability to pay make the similar contribution (Horizontal equity) (1). Preserving equitable access to health services under a system of user fees can be accomplished in three steps. First, the poor population to receive preferential treatment with respect to user fees must be identified. Second, a protection mechanism must be selected and implemented. Third, to ensure that the protection policy is working adequately, an evaluation of its performance is required (9).

A waiver is used to reduce or eliminate fees for the poor based on an assessment of their inability to pay. Exemptions are used to describe when services are automatically provided free because the patient has the characteristic being targeted (2).

Targeting is a welfare concept and a strategy for identifying any group(s) of Persons in a population who are eligible for an intervention or assistance. Two errors often arise in targeting;1, Error of exclusion: excluding those Intended to benefit from a program and 2. Error of inclusion: including those not intended to benefit from a program (3).

There are various administrative issues on achieving equity under cost recovery through direct targeting these range from identification of responsibilities for certifying and verifying eligibility, designing the means for assessing eligibility and the period of validity of these means to measuring the effectiveness and costs of the waivers granted. The literature on the subject in the developing countries suggests that much more work is needed to simply describe existing targeting mean testing and exemption mechanisms and establishing how effective they are (4).

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JUSTIFICATION OF THE STUDY

There is a need to