Household cost of antenatal care and delivery services in a rural community of Kaduna state, northwestern Nigeria

Sambo, Mohd Nasiq; Abdulrazaq, Gobir A; Shamang, Anthony; Ibrahim, Adel

doi:10.4103/0300-1652.110034

Cited by 27 publications

(57 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This, we believe, may be related to their experience and exposure. The results of a recent survey conducted by Sambo et al in Kaduna State in north-western Nigeria were consistent with the results of this study on maternal neonatal and child health service costs [ 30 ]. However, Sambo et al only focused on public PHCs in their research.…”

Section: Discussionsupporting

confidence: 91%

Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria

Chukwu¹,

Garg²,

Eze³

2016

JMIR mHealth uHealth

View full text Add to dashboard Cite

BackgroundNigeria contributes only 2% to the world’s population, accounts for 10% of the global maternal death burden. Health care at primary health centers, the lowest level of public health care, is far below optimal in quality and grossly inadequate in coverage. Private primary health facilities attempt to fill this gap but at additional costs to the client. More than 65% Nigerians still pay out of pocket for health services. Meanwhile, the use of mobile phones and related services has risen geometrically in recent years in Nigeria, and their adoption into health care is an enterprise worth exploring.ObjectiveThe purpose of this study was to document costs associated with a mobile technology–supported, community-based health insurance scheme.MethodsThis analytic cross-sectional survey used a hybrid of mixed methods stakeholder interviews coupled with prototype throw-away software development to gather data from 50 public primary health facilities and 50 private primary care centers in Abuja, Nigeria. Data gathered documents costs relevant for a reliable and sustainable mobile-supported health insurance system. Clients and health workers were interviewed using structured questionnaires on services provided and cost of those services. Trained interviewers conducted the structured interviews, and 1 client and 1 health worker were interviewed per health facility. Clinic expenditure was analyzed to include personnel, fixed equipment, medical consumables, and operation costs. Key informant interviews included a midmanagement staff of a health-management organization, an officer-level staff member of a mobile network operator, and a mobile money agent.ResultsAll the 200 respondents indicated willingness to use the proposed system. Differences in the cost of services between public and private facilities were analyzed at 95% confidence level (P<.001). This indicates that average out-of-pocket cost of services at private health care facilities is significantly higher than at public primary health care facilities. Key informant interviews with a health management organizations and a telecom operator revealed high investment interests. Cost documentation analysis of income versus expenditure for the major maternal and child health service areas—antenatal care, routine immunization, and birth attendance for 1 year—showed that primary health facilities would still profit if technology-supported, health insurance schemes were adopted.ConclusionsThis study demonstrates a case for the implementation of enrolment, encounter management, treatment verification, claims management and reimbursement using mobile technology for health insurance in Abuja, Nigeria. Available data show that the introduction of an electronic job aid improved efficiency. Although it is difficult to make a concrete statement on profitability of this venture but the interest of the health maintenance organizations and telecom experts in this endeavor provides a positive lead.

show abstract

Section: Discussionsupporting

confidence: 91%

Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria

Chukwu¹,

Garg²,

Eze³

2016

JMIR mHealth uHealth

View full text Add to dashboard Cite

show abstract

“…Along with other developing countries, researchers in India have also attempted to answer this question. Many of these studies suggest that the cost of ANCs and delivery (obstetric) care could be catastrophic in low-income settings [ 24 , 14 , 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

High Spending on Maternity Care in India: What Are the Factors Explaining It?

et al. 2016

View full text Add to dashboard Cite

Background and ObjectivesHigh maternity-related health care spending is often cited as an important barrier in utilizing quality health care during pregnancy and childbirth. This study has two objectives: (i) to measure the levels of expenditure on total maternity care in disaggregated components such as ANCs, PNCs, and Natal care expenditure; (ii) to quantify the extent of catastrophic maternity expenditure (CME) incurred by households and identify the factors responsible for it.Methods and FindingsData from the 71st round of the National Sample Survey (2014) was used to estimate maternity expenditure and its predictors. CME was measured as a share of consumption expenditure by different cut-offs. The two-part model was used to identify the factors associated with maternity spending and CME. The findings show that household spending on maternity care (US$ 149 in constant price) is much higher than previous estimates (US$ 50 in constant price). A significant proportion of households in India (51%) are incurring CME. Along with economic and educational status, type of health care and place of residence emerged as significant factors in explaining CME.ConclusionFindings from this study assume importance in the context of an emerging demand for higher maternity entitlements and government spending on public health care in India. To reduce CME, India needs to improve the availability and accessibility of better-quality public health services and increase maternity entitlements in line with maternity expenditure identified in this study.

show abstract

“…User fees for maternal health services contribute to high patronage of faith clinics and traditional medical practitioners increasing the likelihood of avoidable deaths from pregnancy and childbirth [31]. Even when user fees are not impoverishing, financial constraints still significantly limited access to maternal health services in rural Nigeria [32,33]. Similarly, children under 5 years and from poor households are more likely to die than children from rich households in Nigeria [34].…”

Section: Introductionmentioning

confidence: 99%

The community is just a small circle: citizen participation in the free maternal and child healthcare programme of Enugu State, Nigeria

Ogbuabor

Onwujekwe

2018

Global Health Action

View full text Add to dashboard Cite

Background: There is a gap in knowledge about how citizen participation impacts governance of free healthcare policies for universal health coverage in low- and middle-income countries. Objective: This study provides evidence about how social accountability initiatives influenced revenue generation, pooling and fund management, purchasing and capacity of health facilities implementing the free maternal and child healthcare programme (FMCHP) in Enugu State, Nigeria. Methods: The study adopted a descriptive, qualitative case-study design to explore how social accountability influenced implementation of the FMCHP at the state level and in two health districts (Isi-Uzo and Enugu Metropolis) in Enugu State. Data were collected from policymakers (n = 16), providers (n = 16) and health facility committee leaders (n = 12) through in-depth interviews. We also conducted focus-group discussions (n = 4) with 42 service users and document review. Data were analysed using thematic analysis. Results: It was found that health facility committees (HFCs) have not been involved in the generation of funds, fund management and tracking of spending in FMCHP. The HFCs did not also seem to have increased transparency of benefits and payment of providers. The HFCs emerged as the dominant social accountability initiative in FMCHP but lacked power in the governance of free health services. The HFCs were constrained by weak legal framework, ineffectual FMCHP committees at the state and district levels, restricted financial information disclosure, distrustful relationships with policymakers and providers, weak patient complaint system and low use of service charter. Conclusion: The HFCs have not played a significant role in health financing and service provision in FMCHP. The gaps in HFCs’ participation in health financing functions and service delivery need to be considered in the design and implementation of free maternal and child healthcare policies that aim to achieve universal health coverage.

show abstract

Household cost of antenatal care and delivery services in a rural community of Kaduna state, northwestern Nigeria

Cited by 27 publications

References 9 publications

Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria

Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria

High Spending on Maternity Care in India: What Are the Factors Explaining It?

The community is just a small circle: citizen participation in the free maternal and child healthcare programme of Enugu State, Nigeria

Contact Info

Product

Resources

About