Department of Public Health, Institute of Tropical Medicine, B-2000 Antwerpen, Belgium.
Am J Public Health. 2010 Oct;100(10):1845-52. doi: 10.2105/AJPH.2009.179689. Epub 2010 Aug 19.
Lack of access to quality care is the main obstacle to reducing maternal mortality in low-income countries. In many settings, women must pay out-of-pocket fees, resulting in delays, some of them fatal, and catastrophic expenditure that push households into poverty. Various innovative approaches have targeted the poor or exempted specific services, such as cesarean deliveries. We analyzed 8 case studies to better understand current experiments in reducing financial barriers to maternal care. Although service utilization increased in most of the settings, concerns remain about quality of care, equity between rich and poor patients and between urban and rural residents, and financial sustainability to support these new strategies.
在低收入国家,缺乏获得高质量医疗服务的机会是降低孕产妇死亡率的主要障碍。在许多情况下,妇女必须自掏腰包支付费用,这导致了延误,其中一些是致命的,而且灾难性的支出使家庭陷入贫困。各种创新方法针对贫困人口或免除了特定服务,例如剖腹产。我们分析了 8 个案例研究,以更好地了解当前减少孕产妇保健财务障碍的实验。尽管在大多数情况下服务利用率有所增加,但人们仍然对护理质量、贫富患者之间以及城乡居民之间的公平性以及支持这些新策略的财务可持续性表示关注。