scholarly journals How costly is the first prenatal clinic visit? Analysis of out-of-pocket expenditure in rural Sri Lanka - a country with free maternal health care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sajaan Praveena Gunarathne ◽  
Nuwan Darshana Wickramasinghe ◽  
Thilini Chanchala Agampodi ◽  
Indika Ruwan Prasanna ◽  
Suneth Buddhika Agampodi
Keyword(s):  
Sri Lanka ◽  
Maternal Health ◽  
Health Services ◽  
Pregnant Women ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Clinic Visit ◽  
Cross Sectional ◽  
The Mean ◽  
Study Setting

Abstract Background This study aimed to determine the magnitude of and factors associated with out-of-pocket expenditure (OOPE) during the first prenatal clinic visit among pregnant women in Anuradhapura district, Sri Lanka, which provides free maternal healthcare. Methods The study design was a cross-sectional study, and the study setting was 22 Medical Officers of Health (MOOH) areas in Anuradhapura District, Sri Lanka. Data of 1389 pregnant women were analyzed using descriptive statistics and non-parametric tests. Results The mean OOPE of the first prenatal clinic visit was USD 8.12, which accounted for 2.9 and 4.5% of the household income and expenditure, respectively. Pregnant women who used only government-free health services (which are free of charge at the point of service delivery) had an OOPE of USD 3.49. A significant correlation was recorded between household expenditure (rs = 0.095, p = 0.002) and the number of pregnancies (rs = − 0.155, p < 0.001) with OOPE. Education level less than primary education is positively contributed to OOPE (p < 0.05), and utilizing government-free maternal health services lead to a decrease in the OOPE for the first prenatal clinic visit (p < 0.05). Conclusion Despite having free maternal services, the OOPE of the first prenatal clinic visit is high in rural Sri Lanka. One-fifth of pregnant women utilize private health services, and pregnant women who used only government-free maternal health services also spend a direct medical cost for medicines/micronutrient supplements.

scholarly journals How Costly is the First Prenatal Clinic Visit? Analysis of Out-of-Pocket Expenditure in Rural Sri Lanka - A Country With Free Maternal Health Care

2021 ◽  
Author(s):  
Sajaan Praveena Gunarathne ◽  
Nuwan Darshana Wickramasinghe ◽  
Thilini Chanchala Agampodi ◽  
Indika Ruwan Prasanna ◽  
Suneth Buddhika Agampodi
Keyword(s):  
Sri Lanka ◽  
Maternal Health ◽  
Health Services ◽  
Pregnant Women ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Clinic Visit ◽  
Cross Sectional ◽  
The Mean ◽  
Study Setting

Abstract Background: This study aimed to determine the magnitude of and factors associated with out-of-pocket expenditure (OOPE) during the first prenatal clinic visit among pregnant women in Anuradhapura district, Sri Lanka, which provides free maternal healthcare. Methods: The study design was a cross-sectional study, and the study setting was 22 Medical Officers of Health areas in Anuradhapura District, Sri Lanka. Data of 1,389 pregnant women were analyzed using descriptive statistics and non-parametric tests. Results: The mean OOPE of the first prenatal clinic visit was USD 8.12, which accounted for 2.9% and 4.5% of the household income and expenditure, respectively. Pregnant women who used only government-free health services had an OOPE of USD 3.49. A significant correlation was recorded between household expenditure (rs=0.095, p=0.002) and the number of pregnancies (rs=-0.155, p<0.001) with OOPE. Conclusion: Despite having free maternal services, the OOPE of the first prenatal clinic visit is high in rural Sri Lanka. One-fifth of pregnant women utilize private health services, and pregnant women who used only government-free maternal health services also spend a direct medical cost.

scholarly journals Disparity in Maternal Health Services Among the Different Geopolitical Zones in Nigeria

2017 ◽  
Vol 11 (1) ◽  
Author(s):  
Abubakar Sadiq Umar ◽  
Chinaro Kennedy ◽  
Hebatullah Tawfik ◽  
Daniel M. N. Okenu
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Secondary Data ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Health Delivery ◽  
Delivery Services ◽  
The Difference ◽  
Antenatal Visits

Although the use of antenatal and other skilled maternal health delivery services in Nigeria was reported to be on the increase, this research explored whether geopolitical zone of residence and place of domicile are associated with the number of antenatal visits and place of delivery. A quantitative cross-sectional study based on secondary data from the Demographic and Health Survey was used to examine the relationship between women’s geopolitical zone of residence, place of domicile (rural/urban), and the number of antenatal visits (categorized as fewer than four or four or more) and delivery (home or health facility). A total of 33,385 women aged 15–49 years were recruited from 888 clusters spread across all the 36 states and the federal capital territory of Nigeria using a stratified two stage proportionate to size cluster design. A higher proportion of women from the South West and North Central zones had made four or more antenatal care visits compared to the other geopolitical zones. The difference was statistically significant even after controlling for differences in education, income, ethnicity, religion, autonomy, and place of domicile (adjusted odd ratio = 2.062; 95% confidence interval [1.897, 2.241]; <em>p </em>< .05). Healthcare policy makers should consider the potential impact of geopolitical zones and place of domicile to enable the development of an all-inclusive strategy to robustly address maternal health services in Nigeria.

scholarly journals Association between male involvement during antenatal care and use of maternal health services in Mwanza City, Northwestern Tanzania: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036211
Author(s):  
Clara C Natai ◽  
Neema Gervas ◽  
Frybert M Sikira ◽  
Beatrice J Leyaro ◽  
Juma Mfanga ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Antenatal Care ◽  
Male Involvement ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Growth Monitoring ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mwanza City

BackgroundMale involvement in antenatal care (ANC) is among interventions to improve maternal health. Globally male involvement in ANC is low and varies in low-income and middle-income countries including Tanzania where most maternal deaths occur. In Sub-Sahara, men are chief decision makers and highly influence maternal health. In Tanzania information is limited regarding influence of male involvement during ANC on utilisation of maternal health services.ObjectivesTo determine the effect of male involvement during ANC on use of maternal health services in Mwanza, Tanzania.DesignA cross-sectional study conducted from June to July 2019.SettingThis study was conducted at seven randomly selected health facilities providing reproductive, maternal and child health (RCH) services in Mwanza City.ParticipantsIncluded 430 postpartum women who delivered 1 year prior to the study and attending for RCH services (growth monitoring, vaccination, postpartum care).Outcome measures4 or more ANC visits, skilled birth attendant (SBA) use during childbirth and postnatal care (PNC) utilisation 48 hours after delivery.MethodsInterviews and observation of the women’s ANC card were used to collect data. Data was entered, cleaned and analysed by SPSS.ResultsThe mean age of participants was 25.7 years. Of 430 women, 54.4% reported their partners attended ANC at least once, 69.7% reported they attended for four or more ANC visits during last pregnancy, 95% used SBAs during childbirth and 9.2% attended PNC within 48 hours after delivery. Male involvement during ANC was significantly associated with four or more ANC visits (Crude Odds Ratio (COR): 1.90; 95% CI: 1.08–3.35) but not with SBA use or PNC utilisation.ConclusionMale involvement in ANC is still low in Mwanza, as 46% of the partners had not attended with partners at ANC. Alternative strategies are needed to improve participation. Studies among men are required to explore the barriers of participation in overall RCH services.

scholarly journals Utilization of maternal health services in rural Thawang, Rolpa district of Nepal: a community-based cross-sectional study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jahirul Hushen ◽  
Arpaporn Powwattana ◽  
Chockchai Munsawaengsub ◽  
Sukhontha Siri
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Local Level ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Local Context ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Content Type

PurposeThis study aimed to identify the proportion and factors influencing the use of maternal health services (MHS) in rural Thawang, Rolpa, Nepal.Design/methodology/approachThis was a community-based cross-sectional study conducted among 417 mothers who had given birth in the previous two years. Bivariate and multivariate logistic regression was applied to identify associations and predictors.FindingsThe results showed that the use of maternal health services was 50.8%. Adjusting for all other factors in the final model, age group 25–30 years (AOR: 2.30; 95% CI: 1.199–4.422), spouse communication (AOR: 7.31; 95% CI: 2.574–20.791), high accessibility (AOR: 2.552, 95% CI: 1.402–4.643) and high affordability (AOR: 10.89; 95% CI: 4.66–25.445) were significant predictors.Research limitations/implicationsThis is a community-based cross-sectional study, and hence cannot establish causal relationships. The research was conducted in a limited rural area mid-Western Nepal, and this may limit the generalization of results to other settings of the country.Practical implicationsThis research supports to local level government and district health authority to develop and implement need based action to increase maternal health service in the local context.Originality/valueUnderutilization of maternal health services is the result of socioeconomic dynamics, poor access to health services and other physical developments. To increase utilization of maternal health services in rural areas, there is a need to tackle the root cause of health inequality such as reducing poverty, increasing female education, involving women in employment and increasing access to health as a priority development agenda by government authorities. This research supports local level government and district health authorities to develop and implement needs-based action to increase MHS in the local context.

scholarly journals Utilization of Health Facility–Based Delivery Service Among Mothers in Gindhir District, Southeast Ethiopia: A Community-Based Cross-Sectional Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110560
Author(s):  
Demisu Zenbaba ◽  
Biniyam Sahiledengle ◽  
Diriba Dibaba ◽  
Mitiku Bonsa
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Facility ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Delivery Service ◽  
The Past ◽  
Southeast Ethiopia ◽  
Delivery Services

Facility-based delivery service is recognized as intermediation to reduce complications during delivery. Current struggles to reduce maternal mortality in low-and-middle income countries, including Ethiopia, primarily focus on deploying skilled birth attendants and upgrading emergency obstetric care services. This study was designed to assess utilization of health facility–based delivery service and associated factors among mothers who gave birth in the past 2 years in Gindhir District, Southeast Ethiopia. A community-based cross-sectional study design was conducted in Gindhir District from March 1 to 30, 2020, among 736 randomly selected mothers who gave birth in the past 2 years. A multistage sampling technique was used to select the study participants and a pretested, structured questionnaire was used to collect data through face-to-face interviews. The collected data were managed and analyzed using SPSS version 23. Of the 736 mothers interviewed, 609 (82.7%), 95% CI: 80.1, 85.5%, of them used health facilities to give birth in the past 2 years for their last delivery. Mothers who lived in rural areas had 4 or more ANC visits, received 3 or more doses of the TT vaccine, and had good knowledge of maternal health services were found to have a statistically significant association with facility-based delivery service utilization. In Gindhir District, mothers have been using health facility–based delivery services at a high rate for the past 2 years. Higher ANC visits and TT vaccine doses, as well as knowledge of maternal health services and being a rural resident, were all linked to using health facility–based delivery services. As a result, unrestricted assistance must be provided to mothers who have had fewer ANC visits and have poor knowledge on maternal health services.

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