Maternal Healthcare Access Patterns in Uganda: An Examination of the Effects of Out of Pocket Expenses Among Pregnant Women 2006-2011

Posted: 2 Mar 2016

Date Written: March 1, 2016

Abstract

Introduction

Although it is the desire of the government of Uganda to have all pregnant women access vital maternal health care services in health facilities, many women across the country are prevented from accessing them due to high out of pocket payments OOPs incurred across the counter at a time of need.

Objective

To examine the effect of out of pocket (OOPs) expenses among pregnant women in Uganda on access of maternal healthcare services and its outcomes in the period 2006 to 2011.

Methodology

The study used a secondary data set of UDHS looking at the information provided by women of reproductive age bracket 15-49 who had given birth in the last 5 years preceding the survey. The study focused on three areas of contraceptive (knowledge and utilization), maternal healthcare (antenatal visits, place of delivery, checkup) and illness management (prevalence and treatment of fever among pregnant women) and tried to understand how OOPs affected access to these services.

It considered women who had given birth and were within age bracket of 15-49 years during in the reference period 2006 to 2011. A sample size of 4,789 was generated. The outcome variables were antenatal, place of delivery, postpartum checkup, contraceptive knowledge & use, fever treatment. While the independent variables were: out of pocket expenses, residence, age, birth order, education level, wealth index, marital status, employment status, religious affiliations and lack of transport. Data was analysed using STATA version 11, univariate, linear multiple regression and multivariate analyses were done during the study.

The odds ratios were used to determine the effect of independent variables of OOPS and others on those maternal health care outcome variables.

Results

As far as OOPs, the study found out that women failed to access maternal health services to place of delivery, fever treatment, postpartum checkup due to high OOPs positive association to them. Pregnant women were 3.4 times more likely not to delivery at health facility due to high OOPs, 1.2 times more likely not get treatment for fever and , 1.3 times more likely not to be checked during postpartum especially in rural areas due to high OOPs. The same positive association was observed between a woman’s educational attainment and visit to antenatal care clinic and tetanus toxoid injection. Education level of women influenced woman’s place of delivery more so those with no education or primary to so in homes compared their counter parts with higher education who preferred to deliver in a health facility.

Finally, wealth index is positively associated with both place of delivery and contraceptive use in that women in the richest categories of wealth are more likely to have the tetanus injection and deliver their babies at health facilities than their counterparts in the poor and poorest categories of wealth.

Conclusion

In conclusion, this study has underscored the critical importance of the effect of Out of Pocket expenses, socioeconomic development on maternal health outcomes as measured by access against out of pocket expenses.

Positively related to place of delivery were age at birth, birth order, education and wealth. OOPs were negatively associated with tetanus toxoid injection, contraceptive knowledge and use.

Recommendations

To meet the needs of child bearing women in relation to reproductive desires and address maternal health care outcomes of antenatal clinical visits, places of delivery, tetanus injections, contraceptive needs and sickness management, the researcher recommendations:

More programmes that target women of this age (35 plus years) to continue providing vital information and also encourage them to attend antenatal services and those that promote post natal services especially in rural areas.

Suggested Citation

Makombe, Richard, Maternal Healthcare Access Patterns in Uganda: An Examination of the Effects of Out of Pocket Expenses Among Pregnant Women 2006-2011 (March 1, 2016). Available at SSRN: https://ssrn.com/abstract=2740387

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