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Fee exemption for caesarean section in Morocco.

Issam Bennis¹, Vincent De Brouwere

¹IRD, UMR912, Marseille, France; Institut National d'Administration Sanitaire, Rabat, Morocco; and Institute of Tropical Medicine, Antwerp, Belgium. vdbrouwere@itg.be.

Archives of Public Health = Archives Belges De Sante Publique

|September 11, 2012

Summary

This summary is machine-generated.

Morocco's fee exemption policy for caesarean sections did not make them truly free. Patients still incurred significant costs for medications, hospital invoices, and transport, highlighting persistent financial barriers to essential obstetric care.

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Area of Science:

Public Health
Health Economics
Obstetrics

Background:

Financial barriers significantly impede access to emergency obstetric care.
Maternal mortality reduction has been slow, partly due to these financial obstacles.
Morocco implemented a fee exemption policy for delivery and caesarean sections in public hospitals in 2009.

Purpose of the Study:

To estimate the actual costs of caesarean sections from patients' perspectives in Fez, Morocco.
To evaluate the impact of the fee exemption policy on out-of-pocket expenses for caesarean deliveries.

Main Methods:

A study was conducted in April 2010 in three public hospitals in Fez, Morocco.
Semi-structured interviews were performed with 100 women who underwent caesarean sections.
Data collected focused on direct costs incurred by patients.

Main Results:

Patients paid between US$169 and US$291 for caesarean sections.
Costs were higher at the university hospital where the fee exemption was not fully applied.
Key cost drivers included medications, hospital invoices, and transportation.

Conclusions:

Despite the fee exemption policy, caesarean deliveries were not entirely free for patients.
Persistent direct costs, influenced by medication prices and hospital charges, remain a barrier.
The policy likely reduced costs for some but did not eliminate financial burdens for caesarean care.