Costs and Patterns of Financing Maternal Health Care Services in Rural Communities in Northern Nigeria: Evidence for Designing National Fee Exemption Policy.

Nnennaya Kalu-Umeh

doi:10.21106/ijma.21

Abstract

As population and access to information increases, so does the demand for health services. Unfortunately, many people who genuinely require these services do not usually have access to them. To increase access, various financing options have been used. Despite this, maternal morbidity and mortality rates remain high and spending is still largely out of pocket. This study assesses maternal health problems, preferred sources of care and the pattern of financing in a semi-rural community in North Western part of Nigeria. A cross-sectional descriptive study design was used. The study population consisted of women within the reproductive age group who had experienced childbirth 12 months or less prior to the study. A sample size of 240 was drawn using cluster and random sampling techniques. Interviewer administered questionnaires were used and the results were analyzed using Statistical Package for Social Sciences (SPSS). The mean age of the respondents was 29 years and 49% had no personal income. Fever was the commonest problem. Although majority received antenatal care, those who lacked antenatal care mostly cited financial difficulties. Nearly half of the women delivered at home as opposed to a health facility. On average, women spent between Nigerian Naira (N) N1, 350-N14, 850 (USD$9-99) for a total package of maternal health services. Out of pocket spending by the husbands or household heads and the women themselves accounted for 73.3% of expenses. In Nigeria, women are still vulnerable to common and preventable causes of maternal morbidity and mortality due to lack of access to antenatal health care. Out of pocket spending is still a popular method of financing. Harmonization of fee exemption policies can improve access to maternal healthcare.

Highlights

More than two decades after the launch of the Safe Motherhood Campaign in 1987, over half a million women most of whom live in developing countries continue to die of maternal causes each year.[1]
Half of the women delivered at home as opposed to a health facility
Women spent between Nigerian Naira (N) N1, 350-N14, 850 (USD$9-99) for a total package of maternal health services

Summary

Introduction

More than two decades after the launch of the Safe Motherhood Campaign in 1987, over half a million women most of whom live in developing countries continue to die of maternal causes each year.[1]. According to the 2008 National Demographic Health Survey, only 35% of Nigerian women deliver in hospitals and the leading barrier to access is lack of finances for treatment. One in three women mentioned distance and transportation difficulties as the major problem while 41% of the respondents were concerned about lack of drugs.[4] Some other factors that prevent women from accessing maternal health services include indirect costs, women’s lack of authority for decision-making and multiple demands on their time, as well as the attitude of healthcare workers.[5]. As population and access to information increases, so does the demand for health services. Maternal morbidity and mortality rates remain high and spending is still largely out of pocket.This study assesses maternal health problems, preferred sources of care and the pattern of financing in a semi-rural community in North Western part of Nigeria

Objectives

Methods

Results

Discussion

Conclusion