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寻求全民健康覆盖:加纳计划生育对女性的隐性成本。

In search of universal health coverage: the hidden cost of family planning to women in Ghana.

作者信息

Amissah John, Nakua Emmanuel Kwaku, Badu Eric, Amissah Alexander Baba, Lariba Leticia

机构信息

Department of Health Policy Planning, Management and Economics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

出版信息

BMC Res Notes. 2020 Feb 7;13(1):58. doi: 10.1186/s13104-020-4928-2.

Abstract

OBJECTIVE

This study aims to estimate the cost of accessing FP services in Ghana. A cross-sectional design, involving quantitative methods were used to recruit 1194 women who accessed FP services in 336 primary health facilities, selected through a two-stage sampling. Descriptive statistics were used to estimate the cost, using STATA 13.

RESULTS

The average age of the women was 29 ± 6.87. Most women had basic education. The sources of payment for FP services were self-finance, family and sponsorship. The average direct cost of accessing FP services was GHS 7.90 [US$ 1.76]. The cost of FP services was highest for consultation GHS 7.50 [US$ 1.67], Laboratory test/x-ray GHS 6.03 [US$ 1.34], Transportation GHS GHS5.50 [US$ 1.22], Contraceptive GHS 4.73 [US$ 1.05] and Client records Card GHS 3.30 [US$ 0.73]. The cost of FP services was higher for clients visiting private facilities, tertiary level as well as those in urban centers. Clients on average spent 54.21 min traveling at a distance of 3.49 km and wait averagely 18.11 min for each visit. Government stakeholders are encouraged to revise the existing maternal health policies, as well as increase the list of FP services within the exemption package of the NHIS policy.

摘要

目的

本研究旨在估算加纳获得计划生育(FP)服务的成本。采用横断面设计,运用定量方法招募了1194名在336个初级卫生设施中获得FP服务的妇女,这些设施通过两阶段抽样选取。使用描述性统计方法,借助STATA 13估算成本。

结果

这些妇女的平均年龄为29 ± 6.87岁。大多数妇女接受过基础教育。FP服务的支付来源为自费、家庭及赞助。获得FP服务的平均直接成本为7.90加纳塞地(GHS)[1.76美元]。FP服务成本最高的项目为咨询7.50加纳塞地(GHS)[1.67美元]、实验室检查/ X光6.03加纳塞地(GHS)[1.34美元]、交通5.50加纳塞地(GHS)[1.22美元]、避孕药具4.73加纳塞地(GHS)[1.05美元]以及客户记录卡3.30加纳塞地(GHS)[0.73美元]。前往私立机构、三级医疗机构以及城市中心的客户,其FP服务成本更高。客户平均出行距离为3.49公里,花费54.21分钟,每次就诊平均等待18.11分钟。鼓励政府利益相关者修订现有的孕产妇健康政策,并增加国家健康保险计划(NHIS)政策豁免套餐中的FP服务清单。

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