How Costly is the First Prenatal Clinic Visit? Analysis of Out-of-pocket Expenditure in Rural Sri Lanka - a Country with Free Maternal Health Care

Overview

Journal BMC Health Serv Res

Publisher Biomed Central

Specialty Health Services

Date 2021 Sep 17

PMID 34530827

Citations 4

Authors

Sajaan Praveena Gunarathne

Nuwan Darshana Wickramasinghe

Thilini Chanchala Agampodi

Indika Ruwan Prasanna

Suneth Buddhika Agampodi

Affiliations

Soon will be listed here.

Abstract

Background: This study aimed to determine the magnitude of and factors associated with out-of-pocket expenditure (OOPE) during the first prenatal clinic visit among pregnant women in Anuradhapura district, Sri Lanka, which provides free maternal healthcare.

Methods: The study design was a cross-sectional study, and the study setting was 22 Medical Officers of Health (MOOH) areas in Anuradhapura District, Sri Lanka. Data of 1389 pregnant women were analyzed using descriptive statistics and non-parametric tests.

Results: The mean OOPE of the first prenatal clinic visit was USD 8.12, which accounted for 2.9 and 4.5% of the household income and expenditure, respectively. Pregnant women who used only government-free health services (which are free of charge at the point of service delivery) had an OOPE of USD 3.49. A significant correlation was recorded between household expenditure (r = 0.095, p = 0.002) and the number of pregnancies (r = - 0.155, p < 0.001) with OOPE. Education level less than primary education is positively contributed to OOPE (p < 0.05), and utilizing government-free maternal health services lead to a decrease in the OOPE for the first prenatal clinic visit (p < 0.05).

Conclusion: Despite having free maternal services, the OOPE of the first prenatal clinic visit is high in rural Sri Lanka. One-fifth of pregnant women utilize private health services, and pregnant women who used only government-free maternal health services also spend a direct medical cost for medicines/micronutrient supplements.

Citing Articles

Assessment of the productivity loss due to leading maternal ill-health conditions: a follow-up study of a prospective pregnancy cohort in rural Sri Lanka.

Gunarathna S, Wickramasinghe N, Agampodi T, Prasanna I, Agampodi S BMJ Open. 2024; 14(10):e082798.

PMID: 39477261 PMC: 11529687. DOI: 10.1136/bmjopen-2023-082798.

Financing for equity for women's, children's and adolescents' health in low- and middle-income countries: A scoping review.

Bou-Karroum L, Iaia D, El-Jardali F, Abou Samra C, Salameh S, Sleem Z PLOS Glob Public Health. 2024; 4(9):e0003573.

PMID: 39264949 PMC: 11392393. DOI: 10.1371/journal.pgph.0003573.

Out-of-Pocket Expenditure for Antenatal Care Amid Free Health Care Provision: Evidence From a Large Pregnancy Cohort in Rural Sri Lanka.

Gunarathna S, Wickramasinghe N, Agampodi T, Prasanna I, Agampodi S Glob Health Sci Pract. 2023; 11(5).

PMID: 37903576 PMC: 10615247. DOI: 10.9745/GHSP-D-22-00410.

Impact of COVID-19 pandemic on health service utilisation and household economy of pregnant and postpartum women: a cross-sectional study from rural Sri Lanka.

Gunarathna S, Wickramasinghe N, Agampodi T, Prasanna I, Agampodi S BMJ Open. 2023; 13(5):e070214.

PMID: 37247958 PMC: 10230333. DOI: 10.1136/bmjopen-2022-070214.

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