scholarly journals Cost of Ante-natal Care among Health Insurance (HI) Enrollees and Out-of-Pocket (OOP) Payers accessing Maternal Healthcare Services in a Tertiary Health Institution in Southwest Nigeria

2021 ◽  
Vol 9 (2) ◽  
pp. 11-22
Author(s):  
Taofeek Adedayo Sanni
Keyword(s):  
Health Insurance ◽  
Antenatal Care ◽  
Healthcare Services ◽  
Reproductive Age ◽  
P Value ◽  
Maternal Healthcare ◽  
Cross Sectional ◽  
Health Institution ◽  
Total Cost ◽  
Southwest Nigeria

Maternal Mortality Remains A Leading Cause Of Death Among Women Of Reproductive Age Group. This Study Determined The Cost Of Antenatal Care Among Health Insurance (HI) Enrollees And Out-Of-Pocket (OOP) Payers Accessing Maternal Healthcare Services In A Tertiary Health Institution In Southwest Nigeria. A Comparative Cross-Sectional Study Was Carried Out Among 380 Women (190 HI Enrollees And 190 OOP Payers) Attending Antenatal Care Services In A Tertiary Health Institution In Southwest Nigeria Using A Systematic Random Sampling Technique. Data Was Gathered Using An Interviewer-Administered Semi-Structured Questionnaire And Analyzed Using IBM SPSS Version 23. Chi-Square And Binary Logistic Regression Were Used To Assess The Association Between Dependent And Independent Variables And A P-Value Of <0.05 Was Taken As Significant. The Overall Mean Age Of Respondents In This Study Was 33.8 ± 5.0 Years (HI Group: 34.1 ± 4.9 Years And OOP Group: 33.6 ± 5.0 Years). The Mean Total Cost Of Antenatal Care (ANC) Is Lesser For HI Enrollees (₦5,095.2 ± 1,753.1 Equivalent To $13.3 ± 4.6) As Compared With OOP Payers (₦15,050.6 ± 5,548.9 Equivalent To $39.6 ± 14.6). Predictors And Enablers For HI Uptake Are Marital Status, Family Size, Level Of Education, Occupation, Appropriate And Quality HI Package, And Trust In The HI Scheme. It Was Concluded That The Total Cost Of Antenatal Care Is Lower Among The Health Insurance Enrollees Than The Out-Of-Pocket Payers. Therefore, Interventions To Increase Awareness And Designing More Enticing HI Packages Are Recommended.

scholarly journals Cost of Deliveries among Health Insurance (HI) Enrollees and Out-of-Pocket (OOP) Payers Accessing Maternal Healthcare Services in a Tertiary Health Institution in Southwest Nigeria

2021 ◽  
Vol 9 (2) ◽  
pp. 244-254
Author(s):  
Taofeek Adedayo Sanni
Keyword(s):  
Health Insurance ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
P Value ◽  
Cross Sectional ◽  
Health Institution ◽  
Total Cost ◽  
Caesarean Section Delivery ◽  
Southwest Nigeria ◽  
The Mean

Maternal Mortality Is Currently High And Remains One Of The Most Important Public Health Problems In Developing Countries. This Study Determined The Cost Of Vaginal And Caesarean Section Deliveries Among Health Insurance (HI) Enrollees And Out-Of-Pocket (OOP) Payers. A Comparative Cross-Sectional Study Was Carried Out Among 380 Women {(133 Vaginal And 57 Caesarean Section Deliveries Among Each Of HI Enrollees And OOP Payers)} Who Accessed Delivery Services In A Tertiary Health Institution In Southwest Nigeria Using A Systematic Random Sampling Technique. Data Was Gathered Using An Interviewer-Administered Semi-Structured Questionnaire And Analyzed Using IBM SPSS Version 23. P-Value <0.05 Was Taken As Significant. The Overall Mean Age Of Respondents In This Study Was 36.5 ± 4.7years Among The Vaginal Delivery Respondents And 35.8 ± 3.6 Years Among Caesarean Section Delivery Respondents. The Mean Total Cost Of Vaginal Delivery For HI Enrollees {₦14,238.5 ± 4,809.0 ($34.5 ± 12.7)} Is Lesser Than For OOP Payers {₦37,928.5 ± 19,813.0 ($99.8 ± 52.1)}. Furthermore, The Mean Total Cost Of Caesarean Section Delivery For HI Enrollees {₦14,238.5 ± 4,809.0 ($34.5 ± 12.7)} Is Lesser Than For OOP Payers (₦37,928.5 ± 19,813.0 ($99.8 ± 52.1}. 94.1% Of The Non-Insurance Enrollees Were Willing To Join Health Insurance Scheme. It Was Concluded That The Total Cost Of Vaginal And Caesarean Section Deliveries Is Lower Among The Health Insurance Enrollees Than The Out-Of-Pocket Payers. Therefore, Intervention To Increase Awareness On Health Insurance Is Recommended.

scholarly journals Health insurance coverage and maternal healthcare services utilization in Jordan: evidence from the 2017–18 Jordan demographic and health survey

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Petula Fernandes ◽  
Emmanuel Kolawole Odusina ◽  
Bright Opoku Ahinkorah ◽  
Komlan Kota ◽  
Sanni Yaya
Keyword(s):  
Health Insurance ◽  
Antenatal Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Healthcare Services ◽  
Skilled Birth Attendance ◽  
Reproductive Age ◽  
Maternal Healthcare ◽  
Services Utilization ◽  
Birth Attendance

Abstract Background Despite the relationship between health insurance coverage and maternal healthcare services utilization, previous studies in Jordan on the use of maternal healthcare services have mainly focused on patterns and determinants of maternal healthcare services utilization in Jordan. Therefore, this study investigated the relationship between health insurance coverage and maternal healthcare services utilization in Jordan. Methods This study used secondary data published in 2017-18 Jordan Demographic and Health Survey on 4656 women of reproductive age (15–49 years). The independent variable was health insurance coverage and the outcome variable was maternal healthcare services utilization, measured through timing of first antenatal visit, four or more antenatal care visits, and skilled birth attendance. The data were analyzed using descriptive statistics and binary logistic regression. Results Out of the total number of women who participated in the study, 38.2% were not covered by health insurance. With maternal healthcare utilization, 12.5%, 23.2%, and 10.1% respectively, failed to make early first antenatal care visit, complete four or more antenatal care visits and have their delivery attended by a skilled worker. After controlling for the socio-demographic factors, health insurance coverage was associated with increased odds of early timing of first antenatal care visits and completion of four or more antenatal care visits (aOR = 1.33, p < 0.05, aOR = 1.25, p < 0.01, respectively). However, women who were covered by health insurance were less likely to use skilled birth attendance during delivery (aOR = 0.72 p < 0.001). Conclusions Jordanian women with health insurance coverage were more likely to have early first antenatal care visits and complete four or more antenatal care visits. However, they were less likely to have their delivery attended by a skilled professional. This study provides evidence that health insurance coverage has contributed to increased maternal healthcare services utilization, only in terms of number and timing of antenatal care visits in Jordan. It is recommended that policy makers in Jordan should strengthen the coverage of health insurance in the country, especially among women of reproductive age in order to enhance the use of maternal healthcare services in the country.

scholarly journals Maternal healthcare services use in Mwanza Region, Tanzania: A cross-sectional baseline survey

2019 ◽  
Author(s):  
James Orwa ◽  
Michaela Mantel ◽  
Micheal Mugerwa ◽  
Sharon Brownie ◽  
Eunice Siaity Pallangyo ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Postpartum Care ◽  
Reproductive Age ◽  
Antenatal Visit ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Cross Sectional

Abstract Background: Improving maternal health by reducing maternal mortality/morbidity relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania. Methods: A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables. Results: Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups. Conclusion: Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services. Keywords: Antenatal care, health facility delivery, postpartum care, Mwanza, Tanzania

scholarly journals Inequalities in out-of-pocket health expenditure among women of reproductive age: after-effects of national health insurance scheme initiation in Ghana

2021 ◽  
Vol 96 (1) ◽  
Author(s):  
Michael Ekholuenetale ◽  
Amadou Barrow
Keyword(s):  
Health Insurance ◽  
Healthcare Utilization ◽  
Health Expenditure ◽  
Concentration Index ◽  
Insurance Coverage ◽  
Healthcare Services ◽  
Socioeconomic Disadvantage ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Maternal Healthcare

Abstract Background Improvement in maternal healthcare is a public health priority. Unfortunately, in spite of the efforts made over time regarding universal coverage, there remain issues with accessibility and use of healthcare services up to now. In this study, we examined inequalities in out-of-pocket health expenditure among women of reproductive age in Ghana. We analyzed secondary data collected in Ghana Demographic and Health Survey (GDHS) - 2014. A total of 9,002 women of reproductive age were included in this study. Lorenz curves and the concentration index were used to examine neighborhood socioeconomic disadvantage inequalities in out-of-pocket expenditure for maternal healthcare utilization Results About two thirds (66.0%) of women of reproductive age in Ghana were covered by health insurance. In sum, women of high neighborhood socioeconomic disadvantage status had the least out-of-pocket expenditure for total healthcare utilization, laboratory investigations, antenatal care visits, post-natal care visits, care for new born for up to 3 months, and other healthcare services. The converse was however true for family planning service utilization. Using Concentration Index, we quantified the degree of neighborhood socioeconomic disadvantage inequalities in healthcare service utilizations. Conclusion This study showed a gap in health insurance coverage among women of reproductive age. There were also inequalities in out-of-pocket expenditure for healthcare services utilization. It is expedient for stakeholders in the healthcare system to make policies targeted at bridging the neighborhood socioeconomic differences in maternal healthcare use and develop programs to improve women’s financial protection. Moreover, enlightenment on health insurance availability and coverage should focus on women at risk of out-of-pocket expenditure.

scholarly journals Maternal healthcare services use in Mwanza Region, Tanzania: a cross-sectional baseline survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
James Orwa ◽  
Michaela Mantel ◽  
Micheal Mugerwa ◽  
Sharon Brownie ◽  
Eunice Siaity Pallangyo ◽  
...  
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Reproductive Age ◽  
Baseline Survey ◽  
Antenatal Visit ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Cross Sectional

Abstract Background Improving maternal health by reducing maternal mortality/morbidity relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania. Methods A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables. Results Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups. Conclusion Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services.

scholarly journals The Effect of Antenatal Care During Covid -19 on Complications of Pregnant

2021 ◽  
Vol 9 (1) ◽  
pp. 111-125
Author(s):  
Ni Gusti Made Ayu Agung Budhi ◽  
Maryanah Maryanah
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Positive Influence ◽  
High School Education ◽  
Reproductive Age ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
And Child Health

Quality Antenatal Care (ANC) services can prevent complications during pregnancy, but during the Covid-19 pandemic, there is a policy for mothers to postpone ANC visits. The purpose of the study was to find out how the influence of ANC services during the Covid-19 pandemic on the incidence of complications in pregnant women. The research method used is an analytical survey with a Cross-Sectional approach. The number of samples is 110 pregnant women respondents. The statistical test used is the Chi-Square test. The results showed that the age of pregnant women was 92.1% of healthy reproductive age, high school education level was 90.4%, some pregnancies experienced by mothers 2 were 66.7%, work as housewives were 67%. The biggest complication that occurs in pregnant women is anemia (40%). The provision of quality ANC services with 10T has a positive influence on the incidence of complications in pregnancy during the pandemic (p-value <0.05), as well as understanding of the Maternal and Child Health (MCH) book (p-value <0.05) and the anxiety felt by the mother (p-value <0.05) influences the occurrence of complications. The conclusions obtained were the effect of providing quality ANC services with 10 T, understanding of the MCH handbook on the incidence of complications during the covid-19 pandemic.

scholarly journals Maternal healthcare services use in Mwanza Region, Tanzania: A cross-sectional baseline survey

2019 ◽  
Author(s):  
James Orwa ◽  
Michaela Mantel ◽  
Micheal Mugerwa ◽  
Sharon Brownie ◽  
Eunice Siaity Pallangyo ◽  
...  
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Reproductive Age ◽  
Baseline Survey ◽  
Antenatal Visit ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Cross Sectional

Abstract Background Improving maternal health by reducing maternal morbidity and mortality relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania.Methods A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables.Results Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups.Conclusion Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services.

scholarly journals Effectiveness of a free maternal healthcare programme under the National Health Insurance Scheme on skilled care: evidence from a cross-sectional study in two districts in Ghana

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e022614 ◽  
Author(s):  
Peter Twum ◽  
Jing Qi ◽  
Kasangye Kangoy Aurelie ◽  
Lingzhong Xu
Keyword(s):  
Health Insurance ◽  
Antenatal Care ◽  
National Health Insurance ◽  
National Health ◽  
Postnatal Care ◽  
National Health Insurance Scheme ◽  
Maternal Healthcare ◽  
Insurance Scheme ◽  
Cross Sectional ◽  
Healthcare Programme

ObjectivesIn her quest to reduce maternal mortality, Ghana introduced a free maternal healthcare programme under the National Health Insurance Scheme. This study aimed to evaluate if women registered with the insurance had a better chance of accessing maternal healthcare services in two districts in Ghana.SettingWe conducted a cross-sectional quantitative study involving household interviews of all women of the reproductive age group (15–49 years) residing in Kintampo North Municipality and Kintampo South District in Ghana from May to July 2015. Logistics regression analysis at 95% CI was used to determine the independent associations between maternal health insurance and use of antenatal care, facility-based delivery and postnatal care services.ParticipantsWomen who had children aged 3–12 months were selected to take part in the study.ResultsWe observed that women with insurance are 39.5 times more likely to have a maximum of six antenatal care visits and 2.6 times more likely to have an average of four antenatal care visits than those without insurance. Additionally, they are 5.3 times more likely to have facility-based delivery than those without insurance. An association was also found between postnatal care use and insurance as women who do not have insurance are 12.0 (1/0.083) times more likely to receive postnatal care than those with insurance.ConclusionsPregnant women who registered with health insurance had at least four antenatal care visits and delivered in a health facility. However majority of them did not go for postnatal care.

scholarly journals Access to maternal healthcare services among Indigenous women in the Chittagong Hill Tracts, Bangladesh: A cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e033224 ◽  
Author(s):  
Shahinoor Akter ◽  
Jane Louise Rich ◽  
Kate Davies ◽  
Kerry Jill Inder
Keyword(s):  
Primary Outcome ◽  
Care Delivery ◽  
Healthcare Services ◽  
Indigenous Women ◽  
Reproductive Age ◽  
Secondary Outcome ◽  
Chittagong Hill Tracts ◽  
Maternal Healthcare ◽  
Cross Sectional ◽  
Factors Associated

ObjectivesThis study aimed to estimate the prevalence of, and factors associated with, accessing maternal healthcare services (MHC) by Indigenous women in the Chittagong Hill Tracts (CHT), Bangladesh.DesignThis was a cross-sectional survey among Indigenous women of reproductive age.SettingTwo upazillas (subdistricts) of Khagrachhari hill district of the CHT.ParticipantsIndigenous women (15–49 years) within 36 months of delivery were surveyed about accessing MHC services (antenatal care, delivery and postnatal care) for their last pregnancy and delivery.Primary outcome measuresThe primary outcome for this analysis is the prevalence of accessing any MHC service and secondary outcome is factors associated with access to MHC services for Indigenous women during their last pregnancy and childbirth.ResultsOf 438 Indigenous women (220 Chakma, 100 Marma, 118 Tripura) who participated, 75% were aged 16–30 years. With an 89% response rate, a total of 258 (59%) women reported accessing at least one MHC service (Chakma 51.6%, Marma 28%, Tripura 20.5%; p=<0.001). Independent factors associated with accessing MHC after adjusting for clustering were attending secondary school and above (OR 2.4; 95% CI 1.2 to 4.9); knowledge about nearest health facilities (OR 3.8, 95% CI 1.8 to 7.8) and knowledge of pregnancy-related complications (OR 3.0, 95% CI 1.5 to 5.8).ConclusionFindings suggest that the prevalence of accessing MHC services is lower among Indigenous women in the CHT compared with national average. MHC access may be improved through better education and awareness raising of local services.

scholarly journals Maternal healthcare services use in Mwanza Region, Tanzania: A cross-sectional baseline survey

2019 ◽  
Author(s):  
James Orwa ◽  
Michaela Mantel ◽  
Micheal Mugerwa ◽  
Sharon Brownie ◽  
Eunice Siaity Pallangyo ◽  
...  
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Reproductive Age ◽  
Baseline Survey ◽  
Antenatal Visit ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Cross Sectional

Abstract Background Improving maternal health by reducing maternal morbidity and mortality relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania.Methods A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables.Results Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups.Conclusion Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services.

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