Reducing financial barriers to obstetric care in low-income countries

Fabienne Richard, Institute of Tropical Medicine, Antwerp
Sophie Witter, University of Aberdeen

Lack of access to quality care is the main obstacle to reducing maternal mortality in low-income countries. In many settings, women have to pay out-of-pocket fees and this may result in delay – sometimes fatal – and catastrophic expenditure. Although tax-based or social insurance are considered the best alternatives, most countries in high maternal mortality regions such as sub-Saharan Africa and South Asia are unable yet to achieve full coverage. Various innovative approaches have therefore been introduced to target the poor or to exempt specific services, such as caesareans. We have selected different experiences, from fee exemption to cash-assistance, from district-based to national, from Africa to Asia, from universal to poverty-targeted. The aim of this study is to contribute to a better understanding of current experiments in reducing financial barriers to maternal (particularly obstetric) care amongst policy makers.