The economic burden of maternal mortality on households: evidence from three sub-counties in rural western Kenya

Kes, Aslihan; Ogwang, Sheila; Pande, Rohini; Douglas, Zayid; Karuga, Robinson; Odhiambo, Frank; Laserson, Kayla F.; Schaffer, Kathleen

doi:10.1186/1742-4755-12-s1-s3

Cited by 27 publications

(25 citation statements)

References 18 publications

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“…The economic household burden of maternal mortality in rural Kenya was studied by Kes et. al using mixed methods, with focus group discussions to illuminate the economic findings [ 17 ]. While transport, health care during the pregnancy, and delivery costs were high, it was the funeral costs that were the most monumental.…”

Section: Editorialmentioning

confidence: 99%

The true cost of maternal death: individual tragedy impacts family, community and nations

Miller

Belizán

2015

Reprod Health

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The death of a woman in pregnancy and childbirth is globally considered an individual tragedy and a human rights violation. Given the inequities in death that occur to marginalized, poor, and vulnerable women in low and middle income countries, there is no doubt that maternal death is a horrific injustice. However, the long term global burden of disease goes far beyond this tragedy. Recent research is demonstrating that there are disastrous consequences in infant and child mortality, loss of economic opportunities, spiraling cycles of poverty in the families and communities where women die giving birth. The journal Reproductive Health has published a supplement “The True Cost of Maternal Death,” which includes original research from two major study groups. Harvard’s Francois-Xavier Bagnoud (FXB) Center for Health and Human Rights conducted a multi-country, mixed methods study of the impact of maternal mortality on newborn health and survival, family functioning, interrupted education and economic degradation in four high maternal mortality countries, Tanzania, South Africa, Malawi, and Ethiopia. A collaborative group from Family Care International (FCI), the International Center of Research on Women (ICRW), and the Kenya Medical Research Institute (KEMRI)-Center for Disease Control (CDC)-Research Collaboration conducted research into true costs of maternal death in Kenya. These articles demonstrate the enormous costs that ripple out from the maternal death, and the intergenerational and multi-sectorial disruptions related to maternal mortality. It is important in this period of post-MDG strategy planning period that donors, governments, and NGOs be aware not only of the individual level tragedy of the loss of a mother’s life, but also the financial and health costs associated with maternal mortality, and to keep the focus on maternal health as a key issue in all aspects of development, not just health.

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Section: Editorialmentioning

confidence: 99%

The true cost of maternal death: individual tragedy impacts family, community and nations

Miller

Belizán

2015

Reprod Health

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“…Equally so, in our study setting, the financial burden ranged beyond the acute in-hospital phase, involving kin and acquaintances and giving up business ambitions to make ends meet. With a growing body of work on (severe) maternal morbidity and with suggested strong links between poverty and poor health outcomes, as shown in economic studies on maternal mortality [30][31][32][33][34][35], the nexus between economic resources and maternal morbidity deserves to be assessed.…”

Section: The Financial Burdenmentioning

confidence: 99%

“I lost my happiness, I felt half dead and half alive” - a qualitative study of the long-term aftermath of obstetric near-miss in the urban district of Zanzibar, Tanzania

Herklots

Yussuf

Mbarouk

et al. 2020

BMC Pregnancy Childbirth

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Background This study aims to explore the stories of three women from Zanzibar, Tanzania, who survived life-threatening obstetric complications. Their narratives will increase understanding of the individual and community-level burden masked behind the statistics of maternal morbidity and mortality in Tanzania. In line with a recent systematic review of women-centred, qualitative maternal morbidity research, this study will contribute to guidance of local and global maternal health agendas. Methods This two-phased qualitative study was conducted in July-August 2017 and July-August 2018, and involved three key informants, who were recruited from a maternal near-miss cohort in May 2017 in Mnazi Mmoja Hospital, Zanzibar. The used methods were participant observation, interviews (informal, unstructured and semi-structured), participatory methods and focus group discussions. Data analysis relied primarily on grounded theory, leading to a theoretical model, which was validated repeatedly by the informants and within the study team. The findings were then positioned in the existing literature. Approval was granted by Zanzibar’s Medical Ethical Research Committee (reference number: ZAMREC/0002/JUN/17). Results The impact of severe maternal morbidity was found to be multi-dimensional and to extend beyond hospital discharge and thus institutionalized care. Four key areas impacted by maternal morbidities emerged, namely (1) social, (2) sexual and reproductive, (3) psychological, and (4) economic well-being. Conclusions This study showed how three women’s lives and livelihoods were profoundly impacted by the severe obstetric complications they had survived, even up to 16 months later. These impacts took a toll on their physical, social, economic, sexual and psychological well-being, and affected family and community members alike. These findings advocate for a holistic, dignified, patient value-based approach to the necessary improvement of maternal health care in low-income settings. Furthermore, it emphasizes the need for strategies to be directed not only towards quality of care during pregnancy and delivery, but also towards support after obstetric complications.

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“…Maternal mortality, defined as the death of women during pregnancy, childbirth, or in the 42 days after birth, has negative impacts on household economic activity . Households may experience catastrophic health expenditures prior to the maternal death, increasing the risk the household will fall into poverty.…”

Section: Introductionmentioning

confidence: 99%

“…Households may experience catastrophic health expenditures prior to the maternal death, increasing the risk the household will fall into poverty. A study in Kenya found that households that experienced a maternal death spent 30% of annual per‐capita consumption expenditure to cover costs including facility fees, transport, medicines, bedding, food, and hotel stay for the woman and people accompanying the woman to seek care …”

Section: Introductionmentioning

confidence: 99%

Willingness to Pay for a Maternity Waiting Home Stay in Zambia

Vian¹,

Biemba²,

Mataka³

et al. 2016

J Midwife Womens Health

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IntroductionComplications of pregnancy and childbirth can pose serious risks to the health of women, especially in resource‐poor settings. Zambia has been implementing a program to improve access to emergency obstetric and neonatal care, including expansion of maternity waiting homes‐residential facilities located near a qualified medical facility where a pregnant woman can wait to give birth. Yet it is unclear how much support communities and women would be willing to provide to help fund the homes and increase sustainability.MethodsWe conducted a mixed‐methods study to estimate willingness to pay for maternity waiting home services based on a survey of 167 women, men, and community elders. We also collected qualitative data from 16 focus group discussions to help interpret our findings in context.ResultsThe maximum willingness to pay was 5.0 Zambian kwacha or $0.92 US dollars per night of stay. Focus group discussions showed that willingness to pay is dependent on higher quality of services such as food service and suggested that the pricing policy (by stay or by night) could influence affordability and use.DiscussionWhile Zambians seem to value and be willing to contribute a modest amount for maternity waiting home services, planners must still address potential barriers that may prevent women from staying at the shelters. These include cash availability and affordability for the poorest households.

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The economic burden of maternal mortality on households: evidence from three sub-counties in rural western Kenya

Cited by 27 publications

References 18 publications

The true cost of maternal death: individual tragedy impacts family, community and nations

The true cost of maternal death: individual tragedy impacts family, community and nations

“I lost my happiness, I felt half dead and half alive” - a qualitative study of the long-term aftermath of obstetric near-miss in the urban district of Zanzibar, Tanzania

Willingness to Pay for a Maternity Waiting Home Stay in Zambia

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