ABSTRACT
Background: Universal health coverage and healthcare financing for maternal health services are essential for quality care, prevention of complication and a reduction in maternal morbidity and mortality.
Objective:To evaluate the modes of healthcare financing for antenatal and delivery care among pregnant women in a tertiary health facility in South- West Nigeria.
Methods: This is a four-year retrospective review of maternal healthcare financing models adopted by pregnant/postpartum women at the antenatal clinic and labour/delivery unit. Data for health financing in antenatal booking clinic for a four-year period from 2016-2019 and labour & delivery for a two- year period from 2018 and 2019 were reviewed. The information collected were – number of women that paid out-of-pocket for services, number of women that paid for services using health insurance and other means of payment during the period. Data were analysed using SPSS version 23.
Result: A total of 7,129 women accessed antenatal care services during the period under review. About 58.9% of the women paid for antenatal care services out-of-pocket, 36.6% were covered under the health insurance (social and private health insurance). A total of 2,881 women accessed delivery services at the health facility. About 66.4% of the women paid out-of-pocket for both caesarean section and vaginal delivery. Prepaid health insurance was used by about 31% of the women.
Conclusion:Health insurance has been available for over a decade; however prepaid healthcare financing model remains less popular. Out-of-pocket payment constitutes the predominant mode of healthcare financing for maternal healthcare among pregnant women at the tertiary health facility. The out-of-pocket payment exposes the pregnant women and her family to financial burden and catastrophic spending especially in obstetric emergency.
Keywords: Healthcare financing, Out-of-pocket payment, Antenatal care, Health facility-based delivery