Utilization cost of maternity services for childbirth among pregnant women with coronavirus disease 2019 in Nigeria's epicenter

Banke-Thomas, Aduragbemi ORCID: 0000-0002-4449-0131, Makwe, Christian Chigozie, Balogun, Mobolanle, Afolabi, Bosede Bukola, Alex-Nwangwu, Theresa Amaogechukwu and Ameh, Charles Anawo ORCID: 0000-0002-2341-7605 (2021) Utilization cost of maternity services for childbirth among pregnant women with coronavirus disease 2019 in Nigeria's epicenter. International Journal of Gynecology and Obstetrics, 152 (2). pp. 242-248.

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Abstract

<h4>Objective</h4>To estimate utilization costs of spontaneous vaginal delivery (SVD) and cesarean delivery (CD) for pregnant women with coronavirus disease 2019 (COVID-19) at the largest teaching hospital in Lagos, the pandemic's epicenter in Nigeria.<h4>Methods</h4>We collected facility-based and household costs of all nine pregnant women with COVID-19 managed at the hospital. We compared their mean facility-based costs with those paid by pregnant women pre-COVID-19, identifying cost-drivers. We also estimated what would have been paid without subsidies, testing assumptions with a sensitivity analysis.<h4>Results</h4>Total utilization costs ranged from US $494 for SVD with mild COVID-19 to US $4553 for emergency CD with severe COVID-19. Though 32%-66% of facility-based cost were subsidized, costs of SVD and CD during the pandemic have doubled and tripled, respectively, compared with those paid pre-COVID-19. Of the facility-based costs, cost of personal protective equipment was the major cost-driver (50%). Oxygen was the major driver for women with severe COVID-19 (48%). Excluding treatment costs for COVID-19, mean facility-based costs were US $228 (SVD) and US $948 (CD).<h4>Conclusion</h4>Despite cost exemptions and donations, utilization costs remain prohibitive. Regulation of personal protective equipment and medical oxygen supply chains and expansion of advocacy for health insurance enrollments are needed in order to minimize catastrophic health expenditure.

Item Type:	Article
Uncontrolled Keywords:	Coronavirus disease 2019, cost, economic evaluation, maternal health, Nigeria, out&#8208, of&#8208, pocket expenditure, skilled birth attendance
Divisions:	Faculty of Health and Life Sciences
Depositing User:	Symplectic Admin
Date Deposited:	17 May 2021 08:23
Last Modified:	18 Jan 2023 22:47
DOI:	10.1002/ijgo.13436
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3122485