Community loan funds and transport services for obstetric emergencies in northern Nigeria

Essien, E.S.; Ifenne, D. I.; Sabitu, Kabir; Musa, Abdullahi; Alti-Mu'azu, M; Adidu, V; Golji, N; Mukaddas, M

doi:10.1016/s0020-7292(97)00171-9

Cited by 57 publications

(43 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A combination of demand and supply side incentives, as seen in Nicaragua, has improved utilization of preventive services among the poor and our study favors a combined approach (28). In remote rural settings measures are needed at facilitating transport access and a number of measures have been identified including community revolving funds for transport, transporter-community links facilitated by NGOs, and transport vouchers (29)(30)(31). BCC has proved to be effective for birth preparedness and newborn care (32), and in this case calls for inclusion of husbands and inlaws.…”

Section: Discussionmentioning

confidence: 74%

Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan

Riaz

Zaidi

Khowaja

2015

Int J Health Policy Manag

View full text Add to dashboard Cite

Background: A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users' perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted). Methods: A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs) conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Results: Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Conclusion: Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong communitybased behavior change strategies. Implications for policy makers• Contracting out public health facilities can be an effective strategy to improve service delivery for Maternal and Neonatal Health (MNH), however, not sufficient to improve the service utilization. • With poor physical and financial access to health facilities in rural settings, transportation and financial safety nets need to be established. • Cultural and customary trends strongly influence decision-making for MNH services utilization. Therefore, community-based behavior change strategies targeting mothers, spouses and mother-in-laws seem crucial.

show abstract

Section: Discussionmentioning

confidence: 74%

Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan

Riaz

Zaidi

Khowaja

2015

Int J Health Policy Manag

View full text Add to dashboard Cite

show abstract

“…More feasible are schemes that lower the price of travel for health care or provide credit to cover travel expenses. In Africa, community administered and financed funds facilitate travel for emergency obstetric care and provide emergency interest free loans to cover the cost 83,84 . There is evidence of a positive impact on emergency referral rates 3 .…”

Section: Lowering the Barrier Of Distancementioning

confidence: 99%

Access to health care in developing countries: breaking down demand side barriers

2007

View full text Add to dashboard Cite

Access to health care in developing countries: breaking down demand side barriers Acesso aos cuidados de saúde nos países em desenvolvimento: rompendo barreiras contra a demanda IntroductionA large body of evidence confirms that many people in the developing world go without health care from which they could benefit greatly. The poor in developing countries are even less likely than the better off to receive effective health care. Concern for the level and distribution of health in the developing world demands that measures be taken to redress both facts. What are these measures? What policies can increase the utilization of effective health care, particularly by the poor in developing countries?There are two sides to the access problem. On the supply side, good quality, effective health care may not be offered. On the demand side, individuals may not utilize services from which they could benefit. The two are obviously related. Poor quality care will arouse little interest from the public. A high level of demand, made effective by purchasing power, will induce the provision of quality care. Solving the access problem requires tackling both demand and supply side issues. Given the space constraint, this paper will concentrate on the demand side, although a recurring theme will be that the response to demand side measures is dependent on supply side conditions. There is an urgent need to establish mechanisms that can increase the availability and improve the quality of health care in the developing world. For present purposes, let us suppose that effective health care interventions can REVISÃO REVIEW 2820Cad. Saúde Pública, Rio de Janeiro, 23(12):2820

show abstract

“…Community loan and grant funds such as those established under the Prevention of Maternal Mortality Network (PMMN) in parts of Nigeria and Sierra Leone have increasingly been used to help mitigate these costs [56][57][58][59]. These funds do not replace the need for government involvement in financing these costs.…”

Section: Demand-side Costs Are Mostly Not Included In Conventional Fumentioning

confidence: 99%

Effective financing of maternal health services: A review of the literature

Ensor

Ronoh

2005

Health Policy

View full text Add to dashboard Cite

Community loan funds and transport services for obstetric emergencies in northern Nigeria

Abstract: Community-managed loan and transport systems for women with obstetric emergencies can be established and may contribute to reducing delay in obtaining emergency obstetric care.

Cited by 57 publications

References 5 publications

Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan

Perceived barriers to utilizing maternal and neonatal health services in contracted-out versus government-managed health facilities in the rural districts of Pakistan

Access to health care in developing countries: breaking down demand side barriers

Effective financing of maternal health services: A review of the literature

Contact Info

Product

Resources

About