Banke-Thomas, Aduragbemi ORCID: 0000-0002-4449-0131, Makwe, Christian Chigozie, Balogun, Mobolanle, Afolabi, Bosede Bukola, Alex-Nwangwu, Theresa Amaogechukwu and Ameh, Charles Anawo (2021) Utilization cost of maternity services for childbirth among pregnant women with COVID‐19 in Nigeria’s epicenter. International Journal of Gynecology & Obstetrics, 152 (2). pp. 242-248. ISSN 0020-7292 (Print), 1879-3479 (Online) (doi:https://doi.org/10.1002/ijgo.13436)

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Abstract

Objective
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.
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 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).
Conclusion
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
Additional Information:	Special section: From the FIGO Safe Motherhood & Newborn Health Committee. February 2021. This article also appears in: Covid-19 Virtual Issue.
Uncontrolled Keywords:	Coronavirus disease 2019, cost, economic evaluation, maternal health, Nigeria, out-of-pocket expenditure, skilled birth attendance
Subjects:	H Social Sciences > HD Industries. Land use. Labor > HD61 Risk Management R Medicine > RG Gynecology and obstetrics
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM) Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Vulnerable Children and Families
Related URLs:	Publisher
Last Modified:	08 Apr 2022 13:36
URI:	http://gala.gre.ac.uk/id/eprint/34163

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