User costs and informal payments for care in the largest maternity hospital in Kathmandu, Nepal

dc.contributor.author	Simkhada, Padam	en
dc.contributor.author	Teijlingen, van Edwin	en
dc.contributor.author	Sharma, Gaurav	en
dc.contributor.author	Simkhada, Bibha	en
dc.contributor.author	Townend, John	en
dc.date.accessioned	2014-07-16T00:15:00Z
dc.date.available	2014-07-16T00:15:00Z
dc.date.issued	2014-07-16
dc.identifier.uri	http://hdl.handle.net/11400/1351
dc.rights	Αναφορά Δημιουργού-Μη Εμπορική Χρήση-Όχι Παράγωγα Έργα 3.0 Ηνωμένες Πολιτείες	*
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/3.0/us/	*
dc.source	www.hsj.gr	en
dc.subject	Childbirth
dc.subject	Γέννα
dc.subject	Αναπτυσσόμενες χώρες
dc.subject	Ανεπίσημη πληρωμή
dc.subject	Μαιευτική φροντίδα
dc.subject	Διαφθορά
dc.subject	Corruption
dc.subject	Developing countries
dc.subject	Informal payment
dc.subject	Φακελάκι
dc.subject	Obstetric care
dc.title	User costs and informal payments for care in the largest maternity hospital in Kathmandu, Nepal	en
heal.type	journalArticle
heal.classification	Medicine--Nursing
heal.classification	Νοσηλευτική
heal.classificationURI	N/A-Medicine--Nursing
heal.classificationURI	N/A-Νοσηλευτική
heal.keywordURI	http://id.loc.gov/authorities/childrensSubjects/sj96005023
heal.language	en
heal.access	free
heal.recordProvider	Τεχνολογικό Εκπαιδευτικό Ίδρυμα Αθήνας.Σχολή Επαγγελμάτων Υγείας και Πρόνοιας. Τμήμα Νοσηλευτικής	el
heal.publicationDate	2012-06
heal.bibliographicCitation	Simkhada, P., Teijlingen, E. van, Sharma, G., Simkhada, B., Townend, J.. (2012). User costs and informal payments for care in the largest maternity hospital in Kathmandu, Nepal. "Health Science Journal". 6 (2), 317-34.	en
heal.abstract	Background: Maternity care costs in Nepal include formal and informal payment. Formal include for example the cost for blood or drugs; Informal payments can be voluntary such as gratitude payments, or bribes which patients are ‘expected’ to pay to get decent care or any care at all. One problem is that these payments are missing from formal accounts and they are not taken into account in health-policy decision-making. The aim of the present study was to estimate out-of-pocket expenses (formal/informal) for delivery care in the largest government maternity hospital in Kathmandu, Nepal and establish factors that affect informal costs. Methods: We used mixed-methods approach. We used questionnaire-based interviews with 234 women who had delivered in this hospital followed by semi-structured in-depth interviews with sub-sample of ten couples. SPSS software was used for analysis and cross tabulations and chi square tests, binary logistic regression were performed. Results: Women occurred various costs during a hospital confinement. The qualitative data suggested that some, but not all had started to save prior to the delivery. There is a significant association between making informal payments and whether or not the birth was planned to be in hospital or whether it was an emergency, p=0.025, ANC visits, p=0.008, woman’s occupation,p=0.025 and husband’s employment, p=0.022. Logistic regression suggested four factors associated with making informal payments, indicating a possible socio-economic link with ability to make informal payments. Conclusions: Although informal payments around birth itself were not substantial, such payments are very common. Better understanding of informal payments is important as the illegal status of unofficial health care payments means that it is difficult to establish the prevalence of this phenomenon. Moreover it forms a part of the private health expenditure rarely included in the national health statistics, they create perverse incentives, potentially reduce motivation for reform and will provide information about economic barriers to care.	en
heal.publisher	Μαρβάκη, Χριστίνα	el
heal.journalName	Health Science Journal	en
heal.journalType	peer-reviewed
heal.fullTextAvailability	true
heal.dateCreated	2012-04