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Related Experiment Videos

Payment for deliveries in Sierra Leone.

N C Edwards, N J Birkett, P A Sengeh

    Bulletin of the World Health Organization
    |January 1, 1989
    PubMed
    Summary

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    Payment for childbirth services varied significantly by birth attendant type and location in 1982. Financial incentives often favored less trained attendants, potentially discouraging use of professional healthcare for deliveries.

    Area of Science:

    • Health Economics
    • Maternal Health
    • Healthcare Access

    Background:

    • Investigating payment structures for childbirth services is crucial for understanding healthcare access and utilization.
    • Previous studies have highlighted disparities in healthcare payments, particularly in resource-limited settings.

    Purpose of the Study:

    • To analyze the type and amount of payments for delivery services in two districts in 1982.
    • To identify factors influencing payment variations, including birth attendant type, delivery location, and delivery outcome.

    Main Methods:

    • A survey on health status was conducted in 535 randomly selected villages, collecting data on 83.5% of 2591 deliveries.
    • Payment data was analyzed based on cash vs. in-kind payments, type of birth attendant, and place of delivery.
    Keywords:
    AfricaAfrica South Of The SaharaDelivery Of Health CareDelivery--costDemographic FactorsDeveloping CountriesEconomic FactorsEnglish Speaking AfricaFeesFinancial ActivitiesHealthHealth PersonnelHealth ServicesMedicineMedicine, TraditionalObstetrical SurgeryPopulationPopulation CharacteristicsPregnancyPregnancy OutcomesReproductionRural PopulationSierra LeoneSurgeryTreatmentWestern Africa

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    Main Results:

    • Cash was the most common payment method; payments in kind were more frequent for traditional birth attendants (TBAs).
    • Total payment varied significantly by birth attendant (P < 0.00001) and delivery location (P < 0.00001).
    • Professional attendants received higher payments (Le 16.60) than untrained TBAs (Le 4.85). Payments were higher for stillbirths with professional/auxiliary staff but lower with TBAs.

    Conclusions:

    • Significant financial disparities existed in delivery payments, with higher payments for professional services.
    • The study identified financial disincentives for women seeking skilled birth attendants, potentially impacting maternal healthcare seeking behavior.