ArticleClinicoEconomics and outcomes research : CEOR2023
User Fee Exemption Policy Significantly Improved Adherence to Maternal Health Service Utilization in Bahir Dar City, Northwest Ethiopia: A Comparative Cross-Sectional Study.
Article in ClinicoEconomics and outcomes research : CEOR, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Maternal mortality in Ethiopia (2015-2025): a systematic review of recent evidence and determinants.BMC public health · 2025Pooled it
- The magnitude of second-trimester induced abortion and associated factors in Ethiopia: a systematic review and meta-analysis.Frontiers in global women's health · 2025Pooled it
- Article
- Urban-rural disparities in receipt of treatment for obstetric complications in Ethiopia: A multivariate decomposition analysis.PloS one · 2026Article
- Socioeconomic inequities impacting complete continuum of maternal healthcare service utilisation over time in Ethiopia.International journal of health economics and management · 2025Article
- Exploring barriers and facilitators to achieving quality antenatal care in Ethiopia: a qualitative study.BMC health services research · 2025Article
- Impact of Ghana's fee exemption policy on maternal health service utilisation: an inverse probability of treatment weighting analysis of pooled national data.Journal of global health · 2025Article
- Decomposing socioeconomic inequality in skilled birth attendant utilization in Ethiopia: A secondary data analysis.PloS one · 2025Article
- Healthcare-Seeking Behaviour for Obstetric Complications in Ethiopia: A Multilevel Mixed-Effect Analysis.Health services insights · 2025Article
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4 authors.
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Abstract
Background: Increasing free and skilled delivery is a top priority in the global effort to reduce maternal and newborn mortality. Reducing user-fees through exemption policy has contributed to universal health coverage. However, there is scant evidence regarding the effect of exempted maternal services on adherence to utilization in Ethiopia. Thus, this study aimed to assess the effect of fee exemption policy on adherence to maternal health service utilization and its predictors. Methods: A community-based comparative cross-sectional study was conducted in Bahir Dar City. A two-stage multistage sampling was employed; 497 women participated. Data were collected by face-to-face interview; entered and cleaned using Epi-Data 3.1. SPSS version 25 was used for further analysis. Bivariable and multivariable logistic regression models were computed to assess the association between explanatory and outcome variables. An adjusted odds ratio with a 95% confidence interval was used to interpret the degree of association. The effect of fee exemption policy on adherence to maternal health service utilization was measured by propensity score matching. Results: The overall adherence to maternal service utilization was 54.2%. Factors associated with adherence to maternal health service utilization were pregnancy complications [AOR: 4.1, 95% CI (2.32, 7.28)], secondary and above education [AOR: 4.6, 95% CI (1.38, 15.08)], early ANC Conclusion: User fee exemption policy significantly improved adherence to maternal health service utilization. Promoting a fee exemption policy through third-party financing can enhance maternal health service utilization adherence in hard-to-reach settings of Ethiopia by targeting mothers with higher pregnancies, no complications, no autonomy, and less education.
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