Outcome of Increment in User Fees on Utilization of Maternal Health Services in an Urban Comprehensive Health Centre, South-West, Nigeria https://doi.org/10.60787/NMJ-63-5-146
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Keywords
maternal health services (MHS), skilled birth attendance, antenatal care (ANC), user fees, health system, Nigeria
Abstract
Background: Nigeria records one of the highest annual maternal deaths globally, contributing significantly to the high regional burden of maternal mortality in Sub-Saharan Africa. This study determined the outcome of increment in user fees on trends of the utilization of maternal health services (MHS) among pregnant women in an Urban Comprehensive Health Centre in South-West Nigeria.
Methodology: Health facility records of pregnant women were reviewed to describe trends of MHS over a four-year period from May 2012-April 2016. A before and after analytic design was used to determine the outcome of increment in user fees for MHS by over 230% at the beginning of the third year.
Results: A total of 1,038 and 162 pregnant women registered for antenatal care (ANC) services and delivered at the health facility, respectively. There was a decreasing trend of utilization of MHS; 47.1% and 50.6% of the pregnant women registered for ANC and had deliveries, respectively, in the first year and 13.6% and 18%, respectively, during the fourth year. There was a statistically significant reduction in utilization of MHS- ANC registration, HIV testing services and skilled birth attendance- after increment in user fees. However, the reduction in utilization of family planning where there was no increment in user fees was not statistically significant.
Conclusion: There was a decreasing trend in the utilization of MHS during the period, with the increment in user fees being a critical factor. The user fees should be replaced with a robust social health insurance scheme for pregnant women receiving care at the health facility.
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