School of Interdisciplinary Arts and Sciences, University of Washington Tacoma, Tacoma, USA.
Department of Global Health, University of Washington, Seattle, USA.
Reprod Health. 2019 Jul 22;16(1):111. doi: 10.1186/s12978-019-0777-7.
The practice of detaining people who are unable to pay for health care services they have received is widespread in many parts of the world. We aimed to determine the proportion of women and their infants detained for inability to pay for services received at a provincial hospital in the Democratic Republic of the Congo during a 6-week period in 2016. A secondary objective was to determine clinical and administrative staff attitudes and practices about payment for services and detention.
This mixed-methods descriptive case study included a cross-sectional survey and interviews with key informants.
Over half (52%) of the 85 women who were in the maternity ward at Sendwe Hospital and eligible for discharge between August 5 and September 15, 2016 were detained for 1 to 30 days for outstanding bills of United States dollars (USD) 21 to USD 515. Women who were detained were younger, poorer, and had more obstetric complications and caesarean sections than other women. In addition, over one quarter of the infants born to these women had died during delivery or in the first three days of life. Key informant interviews normalized detention as an unfortunate but inevitable consequence of patient poverty and health system resource constraints.
Detention of women and their infants is common at this hospital in the DRC. This represents a violation of human rights and a systemic failure to ensure that all people have access to essential health services and that they not suffer financial hardship due to the price of those services.
在世界许多地方，扣押无力支付所接受医疗服务费用的人是一种普遍做法。我们旨在确定在 2016 年 6 周期间，刚果民主共和国一家省级医院因无力支付所接受服务而被拘留的妇女及其婴儿的比例。次要目的是确定临床和行政人员对服务付费和拘留的态度和做法。
这是一项混合方法描述性案例研究，包括横断面调查和关键知情人访谈。
在 2016 年 8 月 5 日至 9 月 15 日期间，在森德韦医院分娩且有资格出院的 85 名妇女中，有超过一半（52%）因未结清 21 美元至 515 美元的美元账单而被拘留 1 至 30 天。被拘留的妇女比其他妇女更年轻、更贫穷、产科并发症和剖宫产更多。此外，这些妇女所生的婴儿中有超过四分之一在分娩或出生后的头三天死亡。关键知情人访谈将拘留正常化为患者贫困和卫生系统资源限制的不幸但不可避免的后果。
在刚果民主共和国的这家医院，拘留妇女及其婴儿很常见。这代表着对人权的侵犯，也是系统地未能确保所有人都能获得基本的卫生服务，并且不因这些服务的价格而遭受经济困难。
