Please use this identifier to cite or link to this item:
Title: User costs and informal payments for care in the largest maternity hospital in Kathmandu, Nepal
Authors: Simkhada, Padam
Teijlingen, van Edwin
Sharma, Gaurav
Simkhada, Bibha
Townend, John
Item type: Conference publication
Keywords: Childbirth;Γέννα;Αναπτυσσόμενες χώρες;Ανεπίσημη πληρωμή;Μαιευτική φροντίδα;Διαφθορά;Corruption;Developing countries;Informal payment;Φακελάκι;Obstetric care
Subjects: Medicine--Nursing
Issue Date: 16-Jul-2014
Date of availability: 16-Jul-2014
Publisher: Μαρβάκη, Χριστίνα
Abstract: Background: Maternity care costs in Nepal include formal and informal payment. Formal include for example the cost for blood or drugs; Informal payments can be voluntary such as gratitude payments, or bribes which patients are ‘expected’ to pay to get decent care or any care at all. One problem is that these payments are missing from formal accounts and they are not taken into account in health-policy decision-making. The aim of the present study was to estimate out-of-pocket expenses (formal/informal) for delivery care in the largest government maternity hospital in Kathmandu, Nepal and establish factors that affect informal costs. Methods: We used mixed-methods approach. We used questionnaire-based interviews with 234 women who had delivered in this hospital followed by semi-structured in-depth interviews with sub-sample of ten couples. SPSS software was used for analysis and cross tabulations and chi square tests, binary logistic regression were performed. Results: Women occurred various costs during a hospital confinement. The qualitative data suggested that some, but not all had started to save prior to the delivery. There is a significant association between making informal payments and whether or not the birth was planned to be in hospital or whether it was an emergency, p=0.025, ANC visits, p=0.008, woman’s occupation,p=0.025 and husband’s employment, p=0.022. Logistic regression suggested four factors associated with making informal payments, indicating a possible socio-economic link with ability to make informal payments. Conclusions: Although informal payments around birth itself were not substantial, such payments are very common. Better understanding of informal payments is important as the illegal status of unofficial health care payments means that it is difficult to establish the prevalence of this phenomenon. Moreover it forms a part of the private health expenditure rarely included in the national health statistics, they create perverse incentives, potentially reduce motivation for reform and will provide information about economic barriers to care.
Language: English
Citation: Simkhada, P., Teijlingen, E. van, Sharma, G., Simkhada, B., Townend, J.. (2012). User costs and informal payments for care in the largest maternity hospital in Kathmandu, Nepal. "Health Science Journal". 6 (2), 317-34.
Journal: Health Science Journal
Type of Journal: With a review process (peer review)
Access scheme: Publicly accessible
License: Αναφορά Δημιουργού-Μη Εμπορική Χρήση-Όχι Παράγωγα Έργα 3.0 Ηνωμένες Πολιτείες
Appears in Collections:Τόμος 6, τεύχος 2 (Απρ. - Ιουν. 2012)

Files in This Item:
File Description SizeFormat 
6212.pdf490.24 kBAdobe PDFView/Open

This item is licensed under a Creative Commons License Creative Commons