Abstract

IntroductionIn Africa, a majority of women bring their infant to health services for immunization, but few are checked in the postpartum (PP) period. The Missed opportunities for maternal and infant health (MOMI) EU-funded project has implemented a package of interventions at community and facility levels to uptake maternal and infant postpartum care (PPC). One of these interventions is the integration of maternal PPC in child clinics and infant immunization services, which proved to be successful for improving maternal and infant PPC.AimTaking stock of the progress achieved in terms of PPC with the implementation of the interventions, this paper assesses the economic cost of maternal PPC services, for health services and households, before and after the project start in Kaya health district (Burkina Faso).MethodsPPC costs to health services are estimated using secondary data on personnel and infrastructure and primary data on time allocation. Data from two household surveys collected before and after one year intervention among mothers within one year PP are used to estimate the household cost of maternal PPC visits. We also compare PPC costs for households and health services with or without integration. We focus on the costs of the PPC intervention at days 6–10 that was most successful.ResultsThe average unit cost of health services for days 6–10 maternal PPC decreased from 4.6 USD before the intervention in 2013 (Jan-June) to 3.5 USD after the intervention implementation in 2014. Maternal PPC utilization increased with the implementation of the interventions but so did days 6–10 household mean costs. Similarly, the household costs increased with the integration of maternal PPC to BCG immunization.ConclusionIn the context of growing reproductive health expenditures from many funding sources in Burkina Faso, the uptake of maternal PPC led to a cost reduction, as shown for days 6–10, at health services level. Further research should determine whether the increase in costs for households would be deterrent to the use of integrated maternal and infant PPC.

Highlights

  • In Africa, a majority of women bring their infant to health services for immunization, but few are checked in the postpartum (PP) period

  • The average unit cost of health services for days 6–10 maternal postpartum care (PPC) decreased from 4.6 United States Dollars (USD) before the intervention in 2013 (Jan-June) to 3.5 USD after the intervention implementation in 2014

  • The household costs increased with the integration of maternal PPC to Bacillus Calmette-Guérin (BCG) immunization

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Summary

Introduction

In Africa, a majority of women bring their infant to health services for immunization, but few are checked in the postpartum (PP) period. In the sector of Reproductive Maternal Newborn and Child Health (RMNCH) the exemption policies have been affecting for instance [2] 1) antenatal and under-five-year care since 2002; 2) vaccinations under the Expanded Program on Immunization (EPI) for infants up to the age of 11 months and for pregnant women since 2006; 3) services provided under the national Emergency Obstetric and Newborn Care (EmONC) program and childbirth delivery subsidies from 2006 to 2016; 4) a decree providing free health care for children under the age of five and women since early 2016 [2]; 5) subsidies for family planning (FP) since 2009. Several other large initiatives have been introduced since 2015 such as a Performance Based Financing pilot program with the aim notably of upgrading the provision of maternal health services [4,5,6]

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