FRIEDRICH-EBERT-STIFTUNG – A majority working in the shadows Figure 3.3 Payment for medical treatment by sources of finance and urban–rural residence 60% 50% 40% 30% 20% 10% 0% 2.7% 1.3% Urban Rural Senegal 42.0% 54.0% No Cost was Charged 16.6% 22.6% Urban Rural Zambia Urban Rural Kenya 7.5% 6.1% Urban Rural Côte d’Ivoire 80% 60% 40% 20% 0% 46.0% 37.3% Urban Rural Senegal 30.7% 22.8% Urban Rural Zambia Own Savings 38.5% 31.9% Urban Rural Kenya 56.8% 57.4% Urban Rural Côte d’Ivoire 30% 25% 20% 15% 10% 5% 0% 25.8% 8.2% Urban Rural Senegal 2.8% 4.8% Urban Rural Zambia Sale of Assets 6.5% 15.1% Urban Rural Kenya 0.8% 1.1% Urban Rural Côte d’Ivoire 35% 30% 25% 20% 15% 10% 5% 0% . 33.0% 28.4% Urban Rural Senegal 11.8% 5.8% Urban Rural Zambia Taking Loan 26.0% 23.8% 28.4% 15.3% Urban Rural Kenya Urban Rural Côte d’Ivoire 15.1% 12.6% Urban Rural Ethiopia 44.0% 36.9% Urban Rural Ethiopia 23.9% 8.2% Urban Rural Ethiopia 20.8% 21.8% Urban Rural Ethiopia higher incomes who are not satisfied with the quality of free medical services opt for other forms of treatment, for which they have to pay. In all survey countries, households use more of their own savings if they have more financial resources at their disposal and belong to a higher income class. The opposite effect can be observed for external funding. 22