Implementation of Fee-Free Maternal Health-Care Policy in Ghana: Perspectives of Users of Antenatal and Delivery Care Services From Public Health-Care Facilities in Accra

2018 ◽  
Vol 38 (4) ◽  
pp. 259-267 ◽  
Author(s):  
Patricia Anafi ◽  
Wisdom K. Mprah ◽  
Allen M. Jackson ◽  
Janelle J. Jacobson ◽  
Christopher M. Torres ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Care ◽  
Indirect Costs ◽  
Health Care Facilities ◽  
Public Health Care ◽  
Delivery Care ◽  
Care Services ◽  
Care Facilities ◽  
Exemption Policy ◽  
The Government

In 2008, the government of Ghana implemented a national user fee maternal care exemption policy through the National Health Insurance Scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. Although evidence shows that there has been some success with this initiative, there are still issues relating to cost of care to beneficiaries of the initiative. A qualitative study, comprising 12 focus group discussions and 6 interviews, was conducted with 90 women in six selected urban neighborhoods in Accra, Ghana, to examine users’ perspectives regarding the implementation of this policy initiative. Findings showed that direct cost of delivery care services was entirely free, but costs related to antenatal care services and indirect costs related to delivery care still limit the use of hospital-based midwifery and obstetric care. There was also misunderstanding about the initiative due to misinformation created by the government through the media.We recommend that issues related to both direct and indirect costs of antenatal and delivery care provided in public health-care facilities must be addressed to eliminate some of the lingering barriers relating to cost hindering the smooth operation and sustainability of the maternal care fee exemption policy.

scholarly journals Planning universal accessibility to public health care in sub-Saharan Africa

2020 ◽  
Vol 117 (50) ◽  
pp. 31760-31769
Author(s):  
Giacomo Falchetta ◽  
Ahmed T. Hammad ◽  
Soheil Shayegh
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Services ◽  
Health Care Facilities ◽  
Sub Saharan Africa ◽  
Public Health Care ◽  
Care Services ◽  
Universal Accessibility ◽  
Care Facilities ◽  
Sub Saharan

Achieving universal health care coverage—a key target of the United Nations Sustainable Development Goal number 3—requires accessibility to health care services for all. Currently, in sub-Saharan Africa, at least one-sixth of the population lives more than 2 h away from a public hospital, and one in eight people is no less than 1 h away from the nearest health center. We combine high-resolution data on the location of different typologies of public health care facilities [J. Maina et al., Sci. Data 6, 134 (2019)] with population distribution maps and terrain-specific accessibility algorithms to develop a multiobjective geographic information system framework for assessing the optimal allocation of new health care facilities and assessing hospitals expansion requirements. The proposed methodology ensures universal accessibility to public health care services within prespecified travel times while guaranteeing sufficient available hospital beds. Our analysis suggests that to meet commonly accepted universal health care accessibility targets, sub-Saharan African countries will need to build ∼6,200 new facilities by 2030. We also estimate that about 2.5 million new hospital beds need to be allocated between new facilities and ∼1,100 existing structures that require expansion or densification. Optimized location, type, and capacity of each facility can be explored in an interactive dashboard. Our methodology and the results of our analysis can inform local policy makers in their assessment and prioritization of health care infrastructure. This is particularly relevant to tackle health care accessibility inequality, which is not only prominent within and between countries of sub-Saharan Africa but also, relative to the level of service provided by health care facilities.

scholarly journals Disparities in Health in State of Haryana

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Dr. Tarun Bala
Keyword(s):  
Public Health ◽  
Health Care ◽  
Access To Health Care ◽  
Health Care Facilities ◽  
The State ◽  
Public Health Care ◽  
Public Health Services ◽  
Access To Health ◽  
Care Facilities ◽  
The Government

<div><p><em>Equitable health care is feasible through proper resource allocation and access to health care is resolute by health needs and utilization of public health services.</em><em> </em><em>Access to health care, as a determinant of health,  may be unequally distributed if over a period of time  proper policies and reforms are not introduced. Increasing urban-rural socio-economic disparities jeopardized the fairness in social welfare and particularly the equity of access to health care, which has been widely considered a key objective of health care policies, in turn putting the disadvantaged communities in especially vulnerable position by increasing their health risks. The present study is primarily concerned with the analyzing the progress/ availability of public health care facilities during the periods of development in the state of Haryana, India  and  differences in  District level health indicators while discussing the provision, availability, accessibility and utilization of health care facilities in the study area i.e. shortlisted from the State of Haryana. This study concludes disparities in health indictors over a period of time as disparities among the Districts /regions in the   availability of infrastructure and other health indictors. Though, the government has declared socially backwards Districts of Haryana, as  high priority Districts yet, the situation seems as it is and has sans improved or marginally improved .Similarly the lack of proper awareness w.r.t. utilization of available health care facilities  as provided by the Governments both Union and State also contributed to widening of disparities in some backward Districts of Haryana. There has been a dire  need to motivate the people about the proper utilization of available health care services provided by the respective Governments and reconsideration and Redressal of  the health issues  is also required at both levels -  consumption as well services providing provisions .  Access issues is  also essential for informing public decision- and policy-making aimed at  providing better life to its citizen. </em></p></div>

scholarly journals Out-of-pocket health expenditure and fairness in utilization of health care facilities in Cambodia in 2005 and 2010

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 2066 ◽  
Author(s):  
Koustuv Dalal ◽  
Olatunde Aremu ◽  
Gainel Ussatayeva ◽  
Animesh Biswas
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Financing ◽  
Household Survey ◽  
Health Care Facilities ◽  
Public Health Care ◽  
Care Utilization ◽  
Survey Period ◽  
Care Facilities ◽  
The Government

Background: Out-of-pocket (OOP) payments for health care are highly pervasive in several low-and-middle income countries. The Cambodian health system has envisaged massive repositioning of various health care financing to ensure equitable access to health care. This analysis examines catastrophic, economic, as well as fairness, impacts of OOP health care payments on households in Cambodia over time. Methods: Data from two waves of a nationally representative household survey conducted in Cambodia (CDHS Surveys 2005 and 2010) were utilized. Healthcare utilizations based on economic status were compared during 2005 and 2010. Variables of interests were i) where care was sought and the instances of treatments, i.e. was treatment sought the first, second or third time; (ii) the mode of payment for treatment of the respondent or for any household member due to sickness or injury in the last 30 days prior to the survey period. Lorenz curves were applied to assess the degree of distribution of inequality in OOP expenditures between different income brackets. Results: The findings revealed that there was inequality and unfairness in health care payments, and catastrophic spending is more common among the poor in Cambodia. The majority of people from poorer households experienced economic hardship and have taken to catastrophic health care spending through sales of personal possessions.  Conclusion: Based on the findings from this analysis, more attention is needed on effective financial protection for Cambodians to promote fairness. The government should increase spending on services being provided at public health care facilities to reduce ever increasing reliance on private sector providers. These approaches would go a long way to reduce the economic burden of care utilization among the poorest.

CANADA'S FAILURE

PEDIATRICS ◽  
1994 ◽  
Vol 93 (4) ◽  
pp. 569-569
Author(s):  
J. F. L.
Keyword(s):  
Health Care ◽  
New England ◽  
Care Delivery ◽  
Health Care Facilities ◽  
User Fees ◽  
Capital Expenditures ◽  
The Past ◽  
Care Facilities ◽  
Dog Owners ◽  
The Government

The direct costs of Canada's national health insurance are not as troublesome as the distortive effect they have on health care delivery. Health care facilities have been forced to cut back severely on their capital expenditures, thus depleting the availability of advanced medical equipment. As a result, many patients must seek advanced treatment elsewhere. According to a recent study reported in the New England Journal of Medicine, nearly one-third of Canada's doctors have sent patients outside the country for treatment during the past five years. About 10% of all British Columbia residents requiring cancer therapy have been sent to the U.S. In Toronto, because the government doesn't provide enough money for personnel, 3,000 beds have been removed from service, while thousands of patients are on waiting lists for admission. Even where advanced equipment is available, bureaucratic absurdities prevent proper use. According to the April issue of "Fraser Forum," dogs at York Central Hospital in metropolitan Toronto were able to get CAT scans immediately while humans were put on a waiting list. The reason? Canadian patients are not allowed to pay for CAT scans, and the procedure costs too much to operate more than a few hours a day for nonpaying customers. Dog owners, on the other hand, were permitted to pay to use it. The user fees paid by the dog owners allowed the machine to operate longer, thus more human patients could be scanned. When this information was released, instead of considering user fees for humans, the Canadian government banned the tests for dogs!

scholarly journals Attitudes of Pregnant Women Towards Antenatal Care Services Provided in Primary Health Care Facilities of Mbombela Municipality, Mpumalanga Province, South Africa

2020 ◽  
Vol 13 (1) ◽  
pp. 569-575
Author(s):  
Lucia Drigo ◽  
Masane Luvhengo ◽  
Rachel T. Lebese ◽  
Lufuno Makhado
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Healthcare Providers ◽  
Health Care Facilities ◽  
Care Services ◽  
Primary Health ◽  
Care Facilities ◽  
Primary Health Care Facilities

Background: Pregnant woman’s personal experience of antenatal care services can either be positive or negative; however, knowledge and experience appear to be of paramount importance in shaping their attitudes towards any healthcare-related services. This implies that women's experience of antenatal care services may affect their decision for seeking antenatal care in their present pregnancy, which can lead them to delay seeking care. Purpose: This study sought to explore the attitudes of pregnant women towards antenatal care services provided in primary health care facilities of Mbombela Municipality, Mpumalanga Province, South Africa. Methods: A qualitative exploratory descriptive study design was used for this study. Purposive sampling technique was used to sample pregnant women who fail to attend antenatal services as expected. Data were collected through face to face unstructured in-depth interview. A total of eighteen pregnant women participated in the study until data saturation. Data were analysed using Tech’s method of analysis. Results: Results revealed the following theme and sub-themes: Attitudes of pregnant women related to individual perceptions, perceived barriers to utilizing antenatal care services,’ attitudes of healthcare providers, long waiting times in healthcare facilities, lack privacy and confidentiality in healthcare facilities and attitudes of pregnant women related to attendance of antenatal services. Conclusion: Attitudes of pregnant women about antenatal care are shaped by their knowledge and previous encounters with the health care services that they had previously received. It is therefore important to provide women-friendly services. It is recommended that health education regarding the importance of antenatal care services must be given to all women daily in the waiting areas of each primary health care facilities, thus, the healthcare providers should promote the active participation of pregnant women during the health education sessions and provide opportunities to ask questions.

Spatial distribution of public health care facilities in rural areas of Nalanda district, Bihar

2020 ◽  
Vol 66 (4) ◽  
pp. 387-399
Author(s):  
Anand Kumar ◽  
◽  
Dhiraj Kumar Sharma ◽  
Satya Prakash ◽  
Ram Sakal Yadava ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Spatial Distribution ◽  
Community Development ◽  
Rural Areas ◽  
Graphical Representation ◽  
Health Care Facilities ◽  
Public Health Care ◽  
Location Quotient ◽  
Care Facilities

At this critical juncture of time when the whole world is facing a health care emergency due to the occurrence of (SARS-CoV-2) pandemic. It becomes necessary to critically evaluate public health care facilities and their availability to common people to tackle the ongoing crisis rationally. In this regard, this paper tries to study the spatial distribution of public health care facilities and their availability in rural areas of Nalanda district. Location quotient, Lorenz curve and Gini's coefficient have been worked out to find unequal concentration, availability and distribution of public health care facilities across the study area. To show the concentration and distribution of health care facilities over space maps have been drawn on ArcGIS. MS Excel and Word have been used for showing the availability of health care facilities through graphical representation and for tabulation purposes. This paper concludes that community development blocks surrounding district headquarter have a higher concentration and larger availability of rural public health care facilities in comparison to peripheral community development blocks of the study area.

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