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Utilization cost of maternity services for childbirth amongst pregnant women with COVID-19 in Nigeria’s epicenter

Banke-Thomas, Aduragbemi, Chigozie Makwe, Christian, Balogun, Mobolanle, Bukola Afolabi, Bosede, Amaogechukwu Alex-Nwangwu, Theresa and Ameh, Charles ORCID: https://orcid.org/0000-0002-2341-7605 (2021) 'Utilization cost of maternity services for childbirth amongst pregnant women with COVID-19 in Nigeria’s epicenter'. International Journal of Gynecology & Obstetrics, Vol 152, Issue 2, pp. 242-248.

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Abstract

Objective
To estimate utilization cost of spontaneous vaginal delivery (SVD) and caesarean delivery (CD) for pregnant women with Coronavirus Disease (COVID-19) at the largest teaching hospital in Lagos, the pandemic’s epicenter in Nigeria.
Methods
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.
Results
Total utilization cost ranged from US$494 for SVD with mild COVID-19 to US$4,553 for emergency CD with severe COVID-19. Though 32-66% of facility-based cost were subsidized, cost of SVD and CD during the pandemic have doubled and tripled
respectively compared to those paid pre-COVID. Of the facility-based costs, cost of personal protective equipment (PPE) 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).
Conclusion
Despite cost exemptions and donations, utilization costs remain prohibitive. Regulation of PPE and medical oxygen supply chains and expansion of advocacy for health insurance enrolments are needed to minimize catastrophic health expenditure.

Item Type: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Virus Diseases > Viral Respiratory Tract Infections. Respirovirus Infections > WC 505 Viral respiratory tract infections
WQ Obstetrics > WQ 100 General works
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1002/ijgo.13436
Depositing User: Rachel Dominguez
Date Deposited: 27 Oct 2020 11:33
Last Modified: 08 Mar 2021 10:14
URI: https://archive.lstmed.ac.uk/id/eprint/15895

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