Direct patient costs of maternal care and birth-related complications at faith-based hospitals in Madagascar

• Verfasst von: Franke, Mara Anna [VerfasserIn]
• Verfasst von: Ranaivoson, Rinja Mitolotra [VerfasserIn]
• Verfasst von: Rebaliha, Mahery [VerfasserIn]
• Verfasst von: Rasoarimanana, Sahondra [VerfasserIn]
• Verfasst von: Bärnighausen, Till [VerfasserIn]
• Verfasst von: Knauss, Samuel [VerfasserIn]
• Verfasst von: Emmrich, Julius [VerfasserIn]
• Titel: Direct patient costs of maternal care and birth-related complications at faith-based hospitals in Madagascar
• Titelzusatz: a secondary analysis of programme data using patient invoices
• Verf.angabe: Mara Anna Franke, Rinja Mitolotra Ranaivoson, Mahery Rebaliha, Sahondra Rasoarimanana, Till Bärnighausen, Samuel Knauss, Julius Valentin Emmrich
• E-Jahr: 2022
• Jahr: 22 April 2022
• Umfang: 8 S.
• Fussnoten: Gesehen am 30.05.2022
• Titel Quelle: Enthalten in: BMJ open
• Ort Quelle: London : BMJ Publishing Group, 2011
• Jahr Quelle: 2022
• Band/Heft Quelle: 12(2022), 4, Artikel-ID e053823, Seite 1-8
• ISSN Quelle: 2044-6055
• DOI: doi:10.1136/bmjopen-2021-053823
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: catastrophic health expenditure
• Sach-SW: Madagascar
• Sach-SW: maternal healthcare
• Sach-SW: out of pocket payment
• Sach-SW: Sub-Saharan Africa
• K10plus-PPN: 1805157205

Abstract

Objectives We aimed to determine the rate of catastrophic health expenditure incurred by women using maternal healthcare services at faith-based hospitals in Madagascar. - Design This was a secondary analysis of programmatic data obtained from a non-governmental organisation. - Setting Two faith-based, secondary-level hospitals located in rural communities in southern Madagascar. - Participants All women using maternal healthcare services at the study hospitals between 1 March 2019 and 7 September 2020 were included (n=957 women). - Measures We collected patient invoices and medical records of all participants. We then calculated the rate of catastrophic health expenditure relative to 10% and 25% of average annual household consumption in the study region. - Results Overall, we found a high rate of catastrophic health expenditure (10% threshold: 486/890, 54.6%; 25% threshold: 366/890, 41.1%). Almost all women who required surgical care, most commonly a caesarean section, incurred catastrophic health expenditure (10% threshold: 279/280, 99.6%; 25% threshold: 279/280, 99.6%). The rate of catastrophic health expenditure among women delivering spontaneously was 5.7% (14/247; 10% threshold). - Conclusions Our findings suggest that direct patient costs of managing pregnancy and birth-related complications at faith-based hospitals are likely to cause catastrophic health expenditure. Financial risk protection strategies for reducing out-of-pocket payments for maternal healthcare should include faith-based hospitals to improve health-seeking behaviour and ultimately achieve universal health coverage in Madagascar.