Do exemptions from user fees mean free access to health services? A case study from a rural Cambodian hospital

User fee exemption schemes can be pro-poor provided that the fee exemption system is based on effective pre-identification of intended beneficiaries, that these beneficiaries are informed of their right to free health care and that health care providers are reimbursed for the revenue foregone due to exemptions. To be effective in the Cambodian context, exemption schemes need to be underpinned by a range of additional interventions.