ArticleAfrican health sciences2017
Assessing regional variations in the effect of the removal of user fees on facility-based deliveries in rural Zambia.
Article in African health sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The trial behind it
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Who cites it
7 citing papers in PubMed.
- Effect of cost-reduction interventions on facility-based deliveries in Burkina Faso: a controlled interrupted time-series study with multiple non-equivalent dependent variables.Journal of epidemiology and community health · 2023Article
- Universal health coverage and the poor: to what extent are health financing policies making a difference? Evidence from a benefit incidence analysis in Zambia.BMC public health · 2022Article
- Examining the implementation of the Linda Mama free maternity program in Kenya.The International journal of health planning and management · 2021Article
- The impact of introducing ambulance and delivery fees in a rural hospital in Tanzania.BMC health services research · 2021Observational
- Catastrophic health expenditures arising from out-of-pocket payments: Evidence from South African income and expenditure surveys.PloS one · 2020Article
- Removal of user fees and system strengthening improves access to maternity care, reducing neonatal mortality in a district hospital in Lesotho.Tropical medicine & international health : TM & IH · 2019Article
- HIV and NCDs: inevitable interaction in resource limited settings.African health sciences · 2017Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMaternal health remains a concern in sub-Saharan Africa, where maternal mortality averages 680 per 100,000 live births and almost 50% of the approximately 350,000 annual maternal deaths occur. Improving access to skilled birth assistance is paramount to reducing this average, and user fee reductions could help.
objectiveThe aim of this research was to analyse the effect of user fee removal in rural areas of Zambia on the use of health facilities for childbirth. The analysis incorporates supply-side factors, including quantitative measures of service quality in the assessment.
methodThe analysis uses quarterly longitudinal data covering 2003 (q1)-2008 (q4) and controls for unobserved heterogeneity, spatial dependence and quantitative supply-side factors within an Interrupted Time Series design.
resultsUser fee removal was found to initially increase aggregate facility-based deliveries. Drug availability, the presence of traditional birth attendants, social factors and cultural factors also influenced facility-based deliveries at the national level.
conclusionAlthough user fees matter, to a degree, service quality is a relatively more important contributor to the promotion of facility-based deliveries. Thus, in the short-term, strengthening and improving community-based interventions could lead to further increases in facility-based deliveries.
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Registered trials
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