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Arsenault C., Fournier P., Philibert A., Sissoko K., Coulibaly A., Tourigny C., Traore M., Dumont Alexandre. (2013). Emergency obstetric care in Mali : catastrophic spending and its impoverishing effects on households. Bulletin - OMS, 91 (3), 207-216. ISSN 0042-9686

Fichier PDF disponiblehttp://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers17-03/010060777.pdf[ PDF Link ]

Lien direct chez l'éditeur doi:10.2471/blt.12.108969

En Libre Accès sur HAL http://www.hal.inserm.fr/inserm-00821690

Titre
Emergency obstetric care in Mali : catastrophic spending and its impoverishing effects on households
Année de publication2013
Type de documentArticle référencé dans le Web of Science WOS:000316155100011
AuteursArsenault C., Fournier P., Philibert A., Sissoko K., Coulibaly A., Tourigny C., Traore M., Dumont Alexandre.
SourceBulletin - OMS, 2013, 91 (3), p. 207-216. ISSN 0042-9686
RésuméObjective To investigate the frequency of catastrophic expenditures for emergency obstetric care, explore its risk factors, and assess the effect of these expenditures on households in the Kayes region, Mali. Methods Data on 484 obstetric emergencies (242 deaths and 242 near-misses) were collected in 2008-2011. Catastrophic expenditure for emergency obstetric care was assessed at different thresholds and its associated factors were explored through logistic regression. A survey was subsequently administered in a nested sample of 56 households to determine how the catastrophic expenditure had affected them. Findings Despite the fee exemption policy for Caesareans and the maternity referral-system, designed to reduce the financial burden of emergency obstetric care, average expenses were 152 United States dollars (equivalent to 71 535 Communaute Financiere Africaine francs) and 20.7 to 53.5% of households incurred catastrophic expenditures. High expenditure for emergency obstetric care forced 44.6% of the households to reduce their food consumption and 23.2% were still indebted 10 months to two and a half years later. Living in remote rural areas was associated with the risk of catastrophic spending, which shows the referral system's inability to eliminate financial obstacles for remote households. Women who underwent Caesareans continued to incur catastrophic expenses, especially when prescribed drugs not included in the government-provided Caesarean kits. Conclusion The poor accessibility and affordability of emergency obstetric care has consequences beyond maternal deaths. Providing drugs free of charge and moving to a more sustainable, nationally-funded referral system would reduce catastrophic expenses for households during obstetric emergencies.
Plan de classementSanté : généralités [050]
Descr. géo.MALI
LocalisationFonds IRD [F B010060777]
Identifiant IRDfdi:010060777
Lien permanenthttp://www.documentation.ird.fr/hor/fdi:010060777

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