A study of the cost of delivery services and its roie in determining utiiization patterns of pregnant women in the Kintampo district.

ABSTACT

Having a trained birth attendant at every delivery has been identified as the single

most important way of reducing maternal mortality. However most women do not

patronise supervised delivery services even where they are available. Among the

reasons given for this state of affairs is the high cost of accessing the services.

Supervised delivery in this district was estimated at 37% in 1998, which falls below

the national figure of 44%. The actual cost to a woman for accessing this service,

and the role cost plays in determining the utilization by women is not known in this

district.

This study which was undertaken in the Kintampo district of the Brong Ahafo region

of Ghana from May to August 2000 was to investigate the cost of delivery to women

utilizing the various options of delivery: delivery at home, delivery under the

supervision of a TBA and having a supervised delivery. These costs were compared

and their effect on the choice of services by the women investigated. Women who

had delivered in the three months before the study were chosen from three settings

representing good, moderate and poor access to Orthodox health care facilities for

the survey.

It was found out that it cost a woman four to six times more to have a supervised

delivery than to deliver with a TBA or at home. The bulk of the cost was found to be

for services and drugs. Women identified cost as a very important factor in

influencing their decision on where to deliver and ranked it second only to the safety

of their life and that of their babies. Most women indicated their preference for

hospital delivery if cost were not a problem.

It is recommended that to make supervised delivery an attractive option for women

in the Kintampo district, service charges for supervised deliveries are reviewed

downwards, delivery costs are subsidised and more staff are trained to supervise

more deliveries.