文章基本信息

标题：Fee exemption for caesarean section in Morocco
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作者：Issam Bennis ; Vincent De Brouwere
期刊名称：Archives of Public Health
印刷版ISSN：0778-7367
电子版ISSN：0778-7367
出版年度：2012
卷号：70
期号：1
页码：3
DOI：10.1186/0778-7367-70-3
语种：English
出版社：BioMed Central
摘要：Financial barriers are an important obstacle for access to emergency obstetric care and a contributing factor to too slow a reduction in the level of maternal mortality. In Morocco, in 2009, a fee exemption policy for delivery and caesarean section was implemented in public maternity hospitals. As in most countries where a fee exemption policy has been implemented, fee exemption is considered synonym to free care. However, other direct costs may subsist. The objective of this study was to get an estimate of the actual cost of caesarean sections from the patients' perspective. This study was carried out in April 2010 in the three public hospitals in Fez. We carried out semi-structured interviews among a sample of 100 women who gave birth by caesarian section in the public hospitals in Fez. The results showed that households paid between US$169 (95% Confidence Interval (CI): 153, 185) at the provincial and regional hospitals, and US$291 (95% CI: 224-359) at the university hospital (UH) where the fee exemption was not applied. The direct cost of a caesarean was mainly influenced by the price of the drugs the families bought, the invoice paid at UH, and the transport. Finally, although the fee exemption policy for caesareans has probably reduced the total cost for households who did not have access to a poverty card, it has not led to 'truly' free caesarean deliveries.
关键词：Access to care ; caesarean section ; cost of care ; Morocco ; maternal mortality