Healthcare financing for antenatal care and delivery services in a tertiary health facility in south-west Nigeria

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 SouthWest 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 servicesout-of-pocket, 36.6% were covered under the health insurance (social andprivate health insurance). A total of 2,881 women accessed delivery servicesat 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.