ArticleBMJ open2018
Impoverishment and catastrophic expenditures due to out-of-pocket payments for antenatal and delivery care in Yangon Region, Myanmar: a cross-sectional study.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 38 citations in OpenAlex.
- Catastrophic health expenditure, social protection coverage, and financial coping strategies in adults with symptoms of chronic respiratory diseases in Kenya: a cross-sectional study.The Lancet. Global health · 2025Article
- Household Catastrophic Health Expenditures in Maternal Care: A Cross-Sectional Study From Semnan, Iran.Health science reports · 2025Article
- Article
- Giving birth on the way to the clinic: undocumented migrant women's perceptions and experiences of maternal healthcare accessibility along the Thailand-Myanmar border.Reproductive health · 2023Article
- Health insurance coverage and access to maternal healthcare services by women of reproductive age in Nigeria: a cross-sectional study.BMJ public health · 2023Article
- Out-of-Pocket Expenditure for Antenatal Care Amid Free Health Care Provision: Evidence From a Large Pregnancy Cohort in Rural Sri Lanka.Global health, science and practice · 2023Article
- Coverage, inequity and predictors of hepatitis B birth vaccination in Myanmar from 2011-2016: results from a national survey.BMC health services research · 2022Article
- Associations of Chinese diagnosis-related group systems with inpatient expenditures for older people with hip fracture.BMC geriatrics · 2022Article
- Substantial Out-of-Pocket Health Expenditure on Prenatal Check-Ups: Estimates from a Sample of Pregnant Women in Cartagena, Colombia.ClinicoEconomics and outcomes research : CEOR · 2022Article
- Estimating the Impact of COVID-19 Pandemic Related Lockdown on Utilization of Maternal and Perinatal Health Services in an Urban Neighborhood in Delhi, India.Frontiers in global women's health · 2022Article
- A Narrative Synthesis Review of Out-of-Pocket Payments for Health Services Under Insurance Regimes: A Policy Implementation Gap Hindering Universal Health Coverage in Sub-Saharan Africa.International journal of health policy and management · 2021Review
- Out-of-Pocket Costs for Facility-Based Obstetrical Care in Rural Guatemala.Annals of global health · 2021Article
- Cost of Treating Maternal Complications and Associated Factors in Mekelle General Hospital, Northern Ethiopia.Risk management and healthcare policy · 2021Article
- Analysis of Financial Risk Protection Indicators in Myanmar for Paediatric Surgery.World journal of surgery · 2020Article
- Sexual and reproductive health services in universal health coverage: a review of recent evidence from low- and middle-income countries.Sexual and reproductive health matters · 2020Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectives(1) To assess the levels of impoverishment and catastrophic expenditure due to out-of-pocket (OOP) payments for antenatal care (ANC) and delivery care in Yangon Region, Myanmar; and (2) to explore the determinants of impoverishment and catastrophic expenditure. DESIGN, SETTING AND
participantsA community-based cross-sectional survey among women giving birth within the past 12 months in Yangon, Myanmar, was conducted during October to November 2016 using three-stage cluster sampling procedure. OUTCOME MEASURES: Poverty headcount ratio, normalised poverty gap and catastrophic expenditure incidence due to OOP payments in the utilisation of ANC and delivery care as well as the determinants of impoverishment and catastrophic expenditure.
resultsOf 759 women, OOP payments were made by 75% of the women for ANC and 99.6% for delivery care. The poverty headcount ratios after payments increased to 4.3% among women using the ANC services, to 1.3% among those using delivery care and to 6.1% among those using both ANC and delivery care. The incidences of catastrophic expenditure after payments were found to be 12% for ANC, 9.1% for delivery care and 20.9% for both ANC and delivery care. The determinants of impoverishment and catastrophic expenditure were women's occupation, number of household members, number of ANC visits and utilisation of skilled health personnel and health facilities. The associations of the outcomes with these variables bear both negative and positive signs.
conclusionsOOP payments for all ANC and delivery care services are a challenge to women, as one of fifteen women become impoverished and a further one-fifth incur catastrophic expenditures after visiting facilities that offer these services.
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