Investigating household health expenditure during birth period in Blantyre District, Malawi
In Malawi, the majority of women access reproductive health care in public health facilities. The Malawi government policy is for free provision of health services. However, despite the offer of free services, there is now increasing cases of informal payments for members to access services in publi...
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| Format: | Thesis |
| Language: | English |
| Published: |
2021
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| Online Access: | http://nkhokwe.kuhes.ac.mw:8080/handle/20.500.12845/226 |
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Add Tag | Summary: | In Malawi, the majority of women access reproductive health care in public health facilities. The Malawi government policy is for free provision of health services. However, despite the offer of free services, there is now increasing cases of informal payments for members to access services in public health facilities. In public health facilities, informal payments arise as corruption increases resulting in frequent stock outs of essential medical supplies and other informal costs, increased demand of health services due to limited availability of health facilities and shortage of staff. Informal payments are mostly done using out of pocket financing. Effects of these informal payments and other birth related coasts have the potential of denying women services at this critical time as well as access and utilization of services. It is not clear how women are affected by these informal payments while trying to access reproductive health services especially during birth period. This study titled ‘Investigating Household health expenditures during birth period in Blantyre District, Malawi’ aimed at examining health expenditures during birth period in Malawi. In this study, a total of 388 Households were recruited using random sampling method. Data were collected on expenditure and cost attributes incurred by Households during birth period using structured questionnaires. Data analysis was conducted using SPSS version 20.0 and Statistics were presented using frequencies, tables and charts.
About 33% of women were asked to make informal payments while accessing birth services at public health facilities such as medicines, Ultra sound scanning services, laboratory services and cesarean section operations among others. Informal payments were propagated by frequent stock outs of essential medicines and supplies. This is where more births (87%) took place. More than 58% of the charges were done using out of pocket payment as only 10% of participants had Health Insurance as a mode of prepayment. Transportation during the birth period costed from MK9000 to MK45, 000 between public and private transport respectively. More than 50% of women expressed willingness to enrol in a health prepayment organisation if available in their community.
Women rely on public health facilities for birth services because they offer free services. However, informal payments in public health facilities resulting from increasing corruption, increasing demand and limited resources plus other expenses for birth preparedness such as transport are resulting in increased expenditure for birth. Free services are therefore used not as an option but because Households cannot afford paying services using out of pocket expenditures. Malawi has a significant potential to improve maternal health by strengthening strategies that provide financial risk protection to households. The study recommends the establishment of mechanisms that provide financial risk protection for households to attain universal healthcare. There is a need to scale up awareness among the general population to resist all forms of corruption. There is also need to strengthen accountability and transparency mechanisms in the health system to ensure effective monitoring of resources at all levels. |
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