Cost of Health Care and Community Participation

Cost of Health Care and Community Participation

According to merriam-webster online dictionary, defines cost as the amount or equivalent

paid or charged for something. O'Sulliva, (2003) says value of money used up to produce

something, and hence is not available for use any longer is referred as cost. Due to

differences used to evaluate costs, comparisons of costs across studies are difficult. Cross-

country contrasts of cost data are also challenging as the unit costs of interventions may

differ significantly across countries owing to variances in resource availability and costs,

( Odhiambo, 2013). India experiences same economic difficulties and is said to be one of the

key reasons for reduced uptake of maternal healthcare services. For instance in Bihar, one of

poverty. Lack of transport or its exorbitant is one of the barriers to accessing health care for

women in rural areas of Nigeria, not well served by health facilities. The best cost effective

model was described in Nigeria, Ogunjimi, (2012) using trained drivers from local transport

union, with cost per transportation amounting to US$4.67 per case. Example of Ghana

(Senah, Richardson, Kwofie, 1997) specifies that the renewal of a neglected structures to

serve as a health centre and offer MCH/FP clinics was very economical. Costs of patients

have been projected in a number of papers, for instance: antenatal care charges, delivery

care (Knowles 1998); antenatal care charges, delivery care: normal and c-section (Mirembe,

Ssengooba & Lubanga 1998); charges and unofficial fees for c-section in Bangladesh

(Kawnine, Guinness, Amin 1998); direct and indirect costs including charges for antenatal

opposed to a health facility. On average, women spent between Nigerian Naira (N) N1, 350-

N14, 850 (USD$9-99) for a entire package of maternal health services. Out of pocket

expenditure by the husbands or household heads and the women themselves accounted for

73.3% of expenses, (Ogunjimi, 2012)

According to Borghi,et al., (2003) write that a study in Uganda valued the payment of

treatment for postoperative infection with procaine penicillin during an ectopic pregnancy

was at US$31.22 and US$24.50 for ampicillin prophylaxis (including the cost of hospital

admission) (Reggiori, Ravera, Cocozza et al. 1996). The same study projected the price of

antibiotic treatment for postoperative contamination after caesarean section, at US$44.79 for

rural households where women rely on public clinics situated in small towns or cities and

regularly borrow money to cover transport, food and accommodation costs,(Leone T,

James KS, &Padmadas SS2012) Women should never die during pregnancy and childbirth.

Regrettably, no significant progress have been made yet by Kenya in reducing the maternal

mortality rate, which at last stood at 360 maternal deaths per 100,000 births. Over the last 20

years, this rate has only come down by ½ of one percent per year. With year 2015 having

passed, no achievement on MDG 5, (Gill, 2007). WHO, UNICEF, UNFPA and the WB’s,

(2012) report that the government of Kenyan is devoted to eradicating avoidable maternal

deaths, both as a health goal and because of its wider effects for the well-being of Kenya’s

families and communities being hindered by the expenses of provision of maternal

While comparing costs associated with seeking care during pregnancy, labour and

postpartum, discloses that women who died experienced dramatically greater overall costs

than women who experienced safe or uneventful pregnancy and delivery. The charges

during pregnancy included fees, transport costs, and other medical and non-medical costs

incurred outside of the health facility. The average total cost during pregnancy was KES

7,322 for cases and KES 934 for controls, and the average total costs during labour and

postpartum for cases was KES 8,127 compared to controls at KES 1,970, WHO’s (2016).

One woman stated that “Whenever I want to go to the antenatal care, if asked my husband

for transport, he complained that he doesn’t have money, and if I insisted, it resulted in

problems. He gets annoyed easily and will start to insult me”. Asking for money may even

the community at large given their critical roles in the family and society. Nevertheless, half

of the households in cases of maternal death had to seek financing from sources outside of

the household, including fund drive and welfare groups, versus only a fifth of the control

households. In addition, over a quarter of the families reported selling assets, and close to

15% reported seeking help from a financier or lender to pay for burial costs, ( Odhiambo,

2013).

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