User fee exemptions are not enough: out‐of‐pocket payments for ‘free’ delivery services in rural Tanzania

Kruk, Margaret E; Mbaruku, Godfrey; Rockers, Peter C.; Galea, Sandro

doi:10.1111/j.1365-3156.2008.02173.x

Cited by 154 publications

(193 citation statements)

References 31 publications

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“…In Hungary obstetricians and surgeons are the most frequent recipients of informal payments while in Bulgaria, childbirth is commonly the subject of "sizeable" under-the-counter payments [4] According to a study in western Tanzania, a low income country, 73.3% of women reported having made out-ofpocket payments for delivery related costs. The average expenditure represented 8% of the annual per capita income, with nearly half of women reported borrowing money or selling household assets to pay for delivery [21]. In a population-based survey in 2003, in three African countries, women who had given birth in public services were interviewed about the costs during childbirth.…”

Section: Discussionmentioning

confidence: 99%

Informal payments for maternity health services in public hospitals in Greece

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Informal payments for maternity health services in public hospitals in Greece

et al. 2013

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“…Underfunding can cause implementation failure of the policy leading to out-ofpocket payments for 'free' services. For instance, in Tanzania 73.3% of women with facility delivery reported having made out-of-pocket payments for delivery-related costs after abolition of user fees [12].…”

Section: Discussionmentioning

confidence: 99%

The Roles of Infrastructure and Resources on Implementation of Free Maternal Healthcare Services in Machakos Level 5 Hospital, Machakos County, Kenya

Orare¹,

Ann²,

Francis³

et al. 2017

SJPH

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Abstract:Free maternal health care services in Kenya was introduced on 1 st June, 2013 and has increased the number of skilled deliveries significantly. In this paper an attempt is made to examine the factors associated with the utilization of free maternal health care services in Kenya on the basis of data collected from Machakos Level 5 hospital. A descriptive crosssectional study design was used. Using both probability and non-probability sampling techniques; purposive sampling and stratified sampling techniques, a sample of 398 participants who received free maternal services at Machakos level 5 were recruited. A survey questionnaire and interview schedule were administered to women who had delivered in the hospital and interview scheduled was administered to health workers. The findings of the study showed that there is a recognizable relationship between hospital infrastructure and implementation of free maternity services in public hospitals. The study established that there is a positive and significant relationship between patient level of awareness and utilization of free maternal healthcare services. Awareness was sighted as a major structural variable that could influence decision of women to deliver in public hospitals, such knowledge should highlight on requirement and various point of service delivery all of which determined to a great extent the quality of free maternal health services in Kenya.

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“…Aside from using existing data, researchers can design household surveys for a particular question. For instance, Kruk et al (2008) report on a household survey of women in western Tanzania who had given birth in the past five years. They used these data to study informal payments charged for delivery at a health facility, which was legally required to be free.…”

Section: Patient Surveysmentioning

confidence: 99%