The economic burden of maternal mortality on households: evidence from three sub-counties in rural western Kenya
Identifieur interne : 000990 ( Pmc/Checkpoint ); précédent : 000989; suivant : 000991The economic burden of maternal mortality on households: evidence from three sub-counties in rural western Kenya
Auteurs : Aslihan Kes [États-Unis] ; Sheila Ogwang [Kenya] ; Rohini Prabha Pande [États-Unis] ; Zayid Douglas [États-Unis] ; Robinson Karuga [Kenya] ; Frank O. Odhiambo [Kenya] ; Kayla Laserson [États-Unis] ; Kathleen Schaffer [États-Unis]Source :
- Reproductive Health [ 1742-4755 ] ; 2015.
Abstract
This study explores the consequences of a maternal death to households in rural Western Kenya focusing particularly on the immediate financial and economic impacts.
Between September 2011 and March 2013 all households in the study area with a maternal death were surveyed. Data were collected on the demographic characteristics of the deceased woman; household socio-economic status; a history of the pregnancy and health care access and utilization; and disruption to household functioning due to the maternal death. These data were supplemented by in-depth and focus group discussions.
The health service utilization costs associated with maternal deaths were significantly higher, due to more frequent service utilization as well as due to the higher cost of each visit suggesting more involved treatments and interventions were sought with these women. The already high costs incurred by cases during pregnancy were further increased during delivery and postpartum mainly a result of higher facility-based fees and expenses. Households who experienced a maternal death spent about one-third of their annual per capita consumption expenditure on healthcare access and use as opposed to at most 12% among households who had a health pregnancy and delivery. Funeral costs were often higher than the healthcare costs and altogether forced households to dis-save, liquidate assets and borrow money. What is more, the surviving members of the households had significant redistribution of labor and responsibilities to make up for the lost contributions of the deceased women.
Kenya is in the process of instituting free maternity services in all public facilities. Effectively implemented, this policy can lift a major economic burden experienced by a very large number of household who seek maternal health services which can be catastrophic in complicated cases that result in maternal death. There needs to be further emphasis on insurance schemes that can support households through catastrophic health spending.
Url:
DOI: 10.1186/1742-4755-12-S1-S3
PubMed: 26000953
PubMed Central: 4423575
Affiliations:
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PMC:4423575Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The economic burden of maternal mortality on households: evidence from three sub-counties in rural western Kenya</title>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>This study explores the consequences of a maternal death to households in rural Western Kenya focusing particularly on the immediate financial and economic impacts.</p>
</sec>
<sec><title>Methods</title>
<p>Between September 2011 and March 2013 all households in the study area with a maternal death were surveyed. Data were collected on the demographic characteristics of the deceased woman; household socio-economic status; a history of the pregnancy and health care access and utilization; and disruption to household functioning due to the maternal death. These data were supplemented by in-depth and focus group discussions.</p>
</sec>
<sec><title>Results</title>
<p>The health service utilization costs associated with maternal deaths were significantly higher, due to more frequent service utilization as well as due to the higher cost of each visit suggesting more involved treatments and interventions were sought with these women. The already high costs incurred by cases during pregnancy were further increased during delivery and postpartum mainly a result of higher facility-based fees and expenses. Households who experienced a maternal death spent about one-third of their annual per capita consumption expenditure on healthcare access and use as opposed to at most 12% among households who had a health pregnancy and delivery. Funeral costs were often higher than the healthcare costs and altogether forced households to dis-save, liquidate assets and borrow money. What is more, the surviving members of the households had significant redistribution of labor and responsibilities to make up for the lost contributions of the deceased women.</p>
</sec>
<sec><title>Conclusion</title>
<p>Kenya is in the process of instituting free maternity services in all public facilities. Effectively implemented, this policy can lift a major economic burden experienced by a very large number of household who seek maternal health services which can be catastrophic in complicated cases that result in maternal death. There needs to be further emphasis on insurance schemes that can support households through catastrophic health spending.</p>
</sec>
</div>
</front>
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<author><name sortKey="Olsen, Be" uniqKey="Olsen B">BE Olsen</name>
</author>
<author><name sortKey="Hinderaker, Sg" uniqKey="Hinderaker S">SG Hinderaker</name>
</author>
<author><name sortKey="Ulstein, M" uniqKey="Ulstein M">M Ulstein</name>
</author>
<author><name sortKey="Bergsjo, P" uniqKey="Bergsjo P">P Bergsjo</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ronsmans, C" uniqKey="Ronsmans C">C Ronsmans</name>
</author>
<author><name sortKey="Graham, Wj" uniqKey="Graham W">WJ Graham</name>
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<pmc article-type="research-article" xml:lang="en"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Reprod Health</journal-id>
<journal-id journal-id-type="iso-abbrev">Reprod Health</journal-id>
<journal-title-group><journal-title>Reproductive Health</journal-title>
</journal-title-group>
<issn pub-type="epub">1742-4755</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26000953</article-id>
<article-id pub-id-type="pmc">4423575</article-id>
<article-id pub-id-type="publisher-id">1742-4755-12-S1-S3</article-id>
<article-id pub-id-type="doi">10.1186/1742-4755-12-S1-S3</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>The economic burden of maternal mortality on households: evidence from three sub-counties in rural western Kenya</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Kes</surname>
<given-names>Aslihan</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>akes@icrw.org</email>
</contrib>
<contrib contrib-type="author" id="A2"><name><surname>Ogwang</surname>
<given-names>Sheila</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>sheilaogwang@gmail.com</email>
</contrib>
<contrib contrib-type="author" id="A3"><name><surname>Pande</surname>
<given-names>Rohini Prabha</given-names>
</name>
<xref ref-type="aff" rid="I3">3</xref>
<email>rohinipande@jhu.edu</email>
</contrib>
<contrib contrib-type="author" id="A4"><name><surname>Douglas</surname>
<given-names>Zayid</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>akes@icrw.org</email>
</contrib>
<contrib contrib-type="author" id="A5"><name><surname>Karuga</surname>
<given-names>Robinson</given-names>
</name>
<xref ref-type="aff" rid="I4">4</xref>
<email>rkaruga@lvcthealth.org</email>
</contrib>
<contrib contrib-type="author" id="A6"><name><surname>Odhiambo</surname>
<given-names>Frank O</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>fodhiambo@kemricdc.org</email>
</contrib>
<contrib contrib-type="author" id="A7"><name><surname>Laserson</surname>
<given-names>Kayla</given-names>
</name>
<xref ref-type="aff" rid="I5">5</xref>
<email>kel4@cdc.gov</email>
</contrib>
<contrib contrib-type="author" id="A8"><name><surname>Schaffer</surname>
<given-names>Kathleen</given-names>
</name>
<xref ref-type="aff" rid="I6">6</xref>
<email>kschaffer@familycareintl.org</email>
</contrib>
</contrib-group>
<aff id="I1"><label>1</label>
International Center for Research on Women (ICRW), 1120 20th St NW, Suite 500 North, Washington, D.C. 20036, USA</aff>
<aff id="I2"><label>2</label>
Kenya Medical Research Institute (KEMRI), Kisumu, Kenya</aff>
<aff id="I3"><label>3</label>
Independent Consultant, 7118 Willow Avenue, Takoma Park MD 20912, USA</aff>
<aff id="I4"><label>4</label>
LVCT Health, Tivoli Centre, P.O Box: 3294-40100, Kisumu, Kenya</aff>
<aff id="I5"><label>5</label>
Global Disease Detection Program, Centers for Disease Control (CDC)*, 1600 Clifton Rd. Atlanta, GA 30329-4027, USA</aff>
<aff id="I6"><label>6</label>
Family Care International, 588 Broadway #503, New York, NY 10012, USA</aff>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>6</day>
<month>5</month>
<year>2015</year>
</pub-date>
<volume>12</volume>
<issue>Suppl 1</issue>
<supplement><named-content content-type="supplement-title">True costs of maternal death</named-content>
<named-content content-type="supplement-editor">Jose Belizan and Suellen Miller</named-content>
<named-content content-type="supplement-sponsor">Publication charges for this supplement were funded by Family Care International and the FXB Center for Health and Human Rights. The articles have been through the journal's standard peer review process for supplements. The Supplement Editors declare that they have no competing interests.</named-content>
</supplement>
<fpage>S3</fpage>
<lpage>S3</lpage>
<permissions><copyright-statement>Copyright © 2015 Kes et al; licensee BioMed Central Ltd.</copyright-statement>
<copyright-year>2015</copyright-year>
<copyright-holder>Kes et al; licensee BioMed Central Ltd.</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<self-uri xlink:href="http://www.reproductive-health-journal.com/content/12/S1/S3"></self-uri>
<abstract><sec><title>Background</title>
<p>This study explores the consequences of a maternal death to households in rural Western Kenya focusing particularly on the immediate financial and economic impacts.</p>
</sec>
<sec><title>Methods</title>
<p>Between September 2011 and March 2013 all households in the study area with a maternal death were surveyed. Data were collected on the demographic characteristics of the deceased woman; household socio-economic status; a history of the pregnancy and health care access and utilization; and disruption to household functioning due to the maternal death. These data were supplemented by in-depth and focus group discussions.</p>
</sec>
<sec><title>Results</title>
<p>The health service utilization costs associated with maternal deaths were significantly higher, due to more frequent service utilization as well as due to the higher cost of each visit suggesting more involved treatments and interventions were sought with these women. The already high costs incurred by cases during pregnancy were further increased during delivery and postpartum mainly a result of higher facility-based fees and expenses. Households who experienced a maternal death spent about one-third of their annual per capita consumption expenditure on healthcare access and use as opposed to at most 12% among households who had a health pregnancy and delivery. Funeral costs were often higher than the healthcare costs and altogether forced households to dis-save, liquidate assets and borrow money. What is more, the surviving members of the households had significant redistribution of labor and responsibilities to make up for the lost contributions of the deceased women.</p>
</sec>
<sec><title>Conclusion</title>
<p>Kenya is in the process of instituting free maternity services in all public facilities. Effectively implemented, this policy can lift a major economic burden experienced by a very large number of household who seek maternal health services which can be catastrophic in complicated cases that result in maternal death. There needs to be further emphasis on insurance schemes that can support households through catastrophic health spending.</p>
</sec>
</abstract>
<kwd-group><kwd>Maternal death; Kenya; financial costs.</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Kenya</li>
<li>États-Unis</li>
</country>
<region><li>Géorgie (États-Unis)</li>
<li>État de New York</li>
</region>
</list>
<tree><country name="États-Unis"><noRegion><name sortKey="Kes, Aslihan" sort="Kes, Aslihan" uniqKey="Kes A" first="Aslihan" last="Kes">Aslihan Kes</name>
</noRegion>
<name sortKey="Douglas, Zayid" sort="Douglas, Zayid" uniqKey="Douglas Z" first="Zayid" last="Douglas">Zayid Douglas</name>
<name sortKey="Laserson, Kayla" sort="Laserson, Kayla" uniqKey="Laserson K" first="Kayla" last="Laserson">Kayla Laserson</name>
<name sortKey="Pande, Rohini Prabha" sort="Pande, Rohini Prabha" uniqKey="Pande R" first="Rohini Prabha" last="Pande">Rohini Prabha Pande</name>
<name sortKey="Schaffer, Kathleen" sort="Schaffer, Kathleen" uniqKey="Schaffer K" first="Kathleen" last="Schaffer">Kathleen Schaffer</name>
</country>
<country name="Kenya"><noRegion><name sortKey="Ogwang, Sheila" sort="Ogwang, Sheila" uniqKey="Ogwang S" first="Sheila" last="Ogwang">Sheila Ogwang</name>
</noRegion>
<name sortKey="Karuga, Robinson" sort="Karuga, Robinson" uniqKey="Karuga R" first="Robinson" last="Karuga">Robinson Karuga</name>
<name sortKey="Odhiambo, Frank O" sort="Odhiambo, Frank O" uniqKey="Odhiambo F" first="Frank O" last="Odhiambo">Frank O. Odhiambo</name>
</country>
</tree>
</affiliations>
</record>
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