Uganda: improving maternal health care efficiency and financing

Health Reform Prior Serv. 1999 Summer-Fall:7-9.

Abstract

PIP: This article presents the findings of the Partnerships for Health Reform on the efficiency and financing issues of maternal health services of the Ugandan Ministry of Health. A comparison was made between provider and consumer maternal health service expenditures provided by a public and a mission hospital and center, and by 17 private midwives and 20 traditional birth attendants (TBAs). The six areas covered by the study include antenatal care, normal deliveries, cesarean deliveries, postabortion care and postpartum hemorrhage and eclampsia complications. Greater health service cost was noted among mission hospitals compared with public hospitals and health centers, while prices for cesarean deliveries and treatment of obstetrical complications are higher compared with other maternal health services. Records show relative efficiency indications of the various providers, while quality of services were noted among midwives working in hospitals and centers compared with TBAs. Most consumer costs were observed to be lower compared with other care-related expenses except for mission health care cost. Thus, mission facilities recover more financially compared with public health centers and hospitals. Key actions suggested include: increasing health service utilization, streamlining staffing, improving the drug supply, employing midwives, assessing prescription practices, establishing specific times for check-ups, regulating consumer fees and provision of contracting arrangements, intensifying performance incentives, and evaluating user incomes and the ability of the public to pay for health care services.

MeSH terms

  • Africa
  • Africa South of the Sahara
  • Africa, Eastern
  • Delivery of Health Care
  • Developing Countries
  • Economics
  • Efficiency, Organizational*
  • Financial Management*
  • Health
  • Health Services
  • Maternal Health Services*
  • Maternal-Child Health Centers
  • Organization and Administration
  • Primary Health Care
  • Program Evaluation*
  • Research*
  • Uganda