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Research article
Angèle NKOLA MUSAU
Universite de Lubumbashi
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2367-3748
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The aim of this study was to explore and measure the social and economic consequences of the cost of obstetric and neonatal care in Lubumbashi, the Democratic Republic of Congo.
Methods: We conducted a mixed qualitative and quantitative study in the maternity departments of health facilities in Lubumbashi. The qualitative results were based on a case study conducted in 2018 that included 14 respondents (8 parturients, 2 accompanying family members and 4 health care providers). A quantitative cross-sectional analytical study was carried out in 2019 with 411 women who gave birth at 10 referral hospitals. Data were collected for one month at each hospital, and selected parturients were included in the study only if they paid out-of-pocket and at the point of care for costs related to obstetric and neonatal care.
Results: Costs for obstetric and neonatal care averaged US $77, US $207 and US $338 for simple, complicated vaginal and cesarean deliveries, respectively. These health expenditures were greater than or equal to 40% of the ability to pay for 58.4% of households. At the time of delivery, 14.1% of women in childbirth did not have enough money to pay for care. Of those who did, 76.5% spent their savings. When households did not pay for care, mothers and their babies were held for a long time at the place of care. This resulted in prolonged absence of the mother from the household, reduced household income, family conflicts, and the abandonment of the home by the spouse. At the health facility level, the length of stay increased without generating any additional financial benefits. Disrespectful care and the deterioration of the relationships between caregivers and parturients were also recorded.
Conclusion: To reduce the social and economic consequences of care, the government of the DRC should implement a mechanism for subsidizing care and should associate it with a cost-sharing system. This would result in achieving universal health coverage and improving the physical, mental and social health of mothers, their babies and their households.
Keywords
Consequences, Cost, Obstetric and neonatal care, Lubumbashi
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CURRENT STATUS: Under Revision
Version 1
Posted 01 Aug, 2020
No community comments so far
Review #2 received
Received 11 Dec, 2020
Editorial decision: Minor revision
On 11 Dec, 2020
Reviewer #2 agreed
On 30 Sep, 2020
Review #1 received
Received 24 Aug, 2020
Reviewer #1 agreed
On 10 Aug, 2020
Reviewers invited
Invitations sent on 06 Aug, 2020
Editor assigned
On 28 Jul, 2020
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On 27 Jul, 2020
Editor invited
On 27 Jul, 2020
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Subject Areas
Maternal & Fetal Medicine
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This preprint is under consideration at BMC Pregnancy and Childbirth. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Angèle NKOLA MUSAU
Universite de Lubumbashi
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2367-3748
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 01 Aug, 2020
No community comments so far
Review #2 received
Received 11 Dec, 2020
Editorial decision: Minor revision
On 11 Dec, 2020
Reviewer #2 agreed
On 30 Sep, 2020
Review #1 received
Received 24 Aug, 2020
Reviewer #1 agreed
On 10 Aug, 2020
Reviewers invited
Invitations sent on 06 Aug, 2020
Editor assigned
On 28 Jul, 2020
Submission checks complete
On 27 Jul, 2020
Editor invited
On 27 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The aim of this study was to explore and measure the social and economic consequences of the cost of obstetric and neonatal care in Lubumbashi, the Democratic Republic of Congo.
Methods: We conducted a mixed qualitative and quantitative study in the maternity departments of health facilities in Lubumbashi. The qualitative results were based on a case study conducted in 2018 that included 14 respondents (8 parturients, 2 accompanying family members and 4 health care providers). A quantitative cross-sectional analytical study was carried out in 2019 with 411 women who gave birth at 10 referral hospitals. Data were collected for one month at each hospital, and selected parturients were included in the study only if they paid out-of-pocket and at the point of care for costs related to obstetric and neonatal care.
Results: Costs for obstetric and neonatal care averaged US $77, US $207 and US $338 for simple, complicated vaginal and cesarean deliveries, respectively. These health expenditures were greater than or equal to 40% of the ability to pay for 58.4% of households. At the time of delivery, 14.1% of women in childbirth did not have enough money to pay for care. Of those who did, 76.5% spent their savings. When households did not pay for care, mothers and their babies were held for a long time at the place of care. This resulted in prolonged absence of the mother from the household, reduced household income, family conflicts, and the abandonment of the home by the spouse. At the health facility level, the length of stay increased without generating any additional financial benefits. Disrespectful care and the deterioration of the relationships between caregivers and parturients were also recorded.
Conclusion: To reduce the social and economic consequences of care, the government of the DRC should implement a mechanism for subsidizing care and should associate it with a cost-sharing system. This would result in achieving universal health coverage and improving the physical, mental and social health of mothers, their babies and their households.
Figure 1
Figure 2
Figure 3
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