Background: In 2016, the World Health Organization (WHO) published new antenatal care guidelines recommending an increase from four visits during pregnancy to eight contacts with skilled personnel, among other recommendations. Currently there are ongoing discussions in respect to the cost implications and potential outcomes countries can anticipate, if they make this move. Cameroon has adopted the new recommendation without analysis of the cost implication. Notwithstanding, it is imperative to investigate if pregnant women are willing to make this change, the cost implications of such changes, and if pregnant women will be willing to pay the extra cost. This study sets out to find out women’s preferred number of antenatal visits, their willingness to pay for antenatal visits and to perform a cost- benefit analysis of 4 and 8 visits in Bamenda Health District (BHD). Method: An exit interview was conducted using a semi structured interviewer administered questionnaire with women attending antenatal clinic in some 14 health facilities in BHD. The health facilities were chosen purposively. A total of 396 women were interviewed. Results: Our results revealed that 177 (44.7%) of the women preferred 4 antenatal care visits while 174 (43.9%) preferred 8 antenatal care visits and 45 (11.4%) preferred more than 8 antenatal visits. The extra cost for 4 and 8 visits was 10,390FCFA. The average willingness -to –pay (WTP) for 4 extra visits was calculated to be 2,209FCFA. Conclusion: Although women preferred a model of antenatal care (ANC) with 8 or more ANC contacts, they were not willing to pay for the contacts, thus it is recommended that the 4 visits model be implemented in the Bamenda Health District.
| Published in | International Journal of Health Economics and Policy (Volume 6, Issue 3) |
| DOI | 10.11648/j.hep.20210603.11 |
| Page(s) | 79-84 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Cost, Benefit, Four ANC Visits, Eight ANC Visits, ANC Visit, Cameroon
| [1] | Alkema L, Chou D, Hogan D, Zhang S, Moller A-b, Gemmill A, Fat DM, Boerma T. (2015). Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN maternal mortality estimation inter-agency Group. Lancet.; 6736: 1–13. |
| [2] | Tuncalp Ö, Were WM, MacLennan C, Oladapo OT, Gulmezoglu AM, Bahl R, Daelmans B, Mathai M, Say L, Kristensen F, € Temmerman M, Bustreo F. (2015). Quality of care for pregnant women and newborns—the WHO vision. BJOG; 122: 1045–1049. |
| [3] | WHO. (2018). Maternal Mortality. |
| [4] | Verla, ET, Ojong-Alasia, M., Sama, J., Tumasang, E Ndipowa, J., Atanga, M. (2016). "Various Health Care Providers’ Knowledge of the Partogram Use during Childbirth, at the Bamenda Health District, Cameroon", Asian Journal of Medicine and Health. |
| [5] | Institut National de la Statistique de la République du Cameroun. (2011). Enquête Dé¬mographique et de Santé et à Indicateurs Multiples. Yaounde (Cameroon). Retrieved from http://dhsprogram.com/pubs/pdf/FR260/FR260.pdf. |
| [6] | Meh, C; Thind, A. and Terry, AL. (2020). Ratios and determinants of maternal mortality: a comparison of geographic differences in the northern and southern regions of Cameroon. Meh et al. BMC Pregnancy and Childbirth 20: 194 https://doi.org/10.1186/s12884-020-02879-y accessed June 15, 2020. |
| [7] | Finlayson, K. W. and Downe, S. 2013. Why do women not use antenatal services in low and middle income countries? A metasynthesis of qualitative studies. PLoS Medicine, 10 (1): e1001373. doi: 10.1371/journal.pmed.1001373. |
| [8] | Ngxongo, TSP. (2015). Implementation of the Basic Antenatal Care approach: A tailored practice framework for eThekwini District, KwaZulu-Natal. PhD thesis. |
| [9] | Ngxongo, TSP. (2019). "Chapter 1 Basic Antenatal Care Approach to Antenatal Care Service Provision", Intech Open. |
| [10] | Prata N, Sreenivas A, Greig F, Walsh J, Potts M. (2010). Setting priorities for safe motherhood interventions in resource-scarce settings. Health Policy; 94: 1–13. |
| [11] | Hitimana R. Lindholm L., Krantz G., Nzayirambaho M. and Pulkki-Brännström, A. (2018). Cost of Antenatal care for the health sector and for households in Rwanda. BMC Health Services Research. |
| [12] | Saad–Haddad, G., DeJong, J., Terreri, N., Restrepo–Méndez, M., Perin, J., Vaz, L., Newby, H., Amouzou, A., Barros, A. and Bryce, J. (2016). Patterns and determinants of antenatal care utilization: analysis of national survey data in seven countdown countries. J Glob Health. 6 (1): 010404. |
| [13] | World Health Organization. (2016). WHO Recommendations on Antenatal Care for a positive pregnancy experience. Geneva, Switzerland. |
| [14] | Souza JP, Gülmezoglu AM, Vogel J, Carroli G, Lumbiganon P, Qureshi Z et al (2013). Moving beyond essential interventions for reduction of maternal mortality (the WHO Multi-country Survey on Maternal and Newborn Health): a cross sectional study. Lancet. 381 (9879): 1747–55. doi: 10.1016/S0140-6736(13)60686-8. |
| [15] | UNICEF Cameroon Country Programme 2018-2020 Strategy Note Cameroon Health Programme 2018-2020. Available at: http://files.unicef.org/transparency/documents/Cameroon_Strategy%20Note%20-%20Health%20-%20final%20sd.pdf. |
| [16] | Ekabua, J., Ekabua, K. and Njoku, C. 2011. Proposed framework for making focussed antenatal care services accessible: a review of the Nigerian setting. ISRN Obstetrics and Gynecology. doi: 10.5402/2011/253964 ID 253964. |
| [17] | Chorongo, D., Okinda, F., Kariuki, E., Mulewa, E., Ibinda, F., Muhula, S., Kimathi, G., andMuga, R. (2016). Factors influencing the utilization of focused antenatal care services in Malindi and Magarini sub-counties of Kilificounty, Kenya. The Pan African Medical Journal. 25 (Supp 2): 14. doi: 10.11604/pamj.supp.2016.25.2.10520. |
| [18] | Manzi, A., Nyirazinyoye, L, Ntaganira, J., Magge, H., Bigirimana, E., Mukanzabikeshimana, L, Hirschhorn LR., and Hedt-Gauthier, B. (2018). Beyond coverage: improving the quality of antenatal care delivery through integrated mentorship and quality improvement at health centers in rural Rwanda. BMC Health Services Research. 18: 136 https://doi.org/10.1186/s12913-018-2939-7. |
| [19] | Oshinyemi1, T., Aluko, J. and Oluwatosin, O. (2018). Focused antenatal care: Re-appraisal of current practices. International Journal of Nursing and Midwifery. Vol. 10 (8), pp. 90-98. DOI: 10.5897/IJNM2018.0312 [accessed on 22 Jan 2019]. |
| [20] | WHO. (2001). WHO antenatal care randomized trial: manual for the implementation of the new model. Geneva: World Health Organization, 2001. www.who.int/entity/reproductivehealth/publications/maternal_perinatal_health/RHR_01_30/en/. |
| [21] | World Health Organization (2002). Antenatal Care Randomized Trial: Manual for the Implementation of the New Model. Geneva. http://apps.who.int/iris/handle/10665/42513. |
| [22] | Olamijulo JA, Oluwole AA, Babah OA, Aderolu MB, Okunola HA, Sanusi MM (2015). Acceptability of Focused Antenatal care by pregnant Nigerian Women and Factors Influencing it. Tropical Journal of Obstetrics and Gynaecology 32 (2): 90-96 [accessed on 22 Jan 2019]. |
| [23] | Mchenga, M. Burger, R. and von Fintel, D. (2019). Examining the impact of WHO’s Focused Antenatal Care policy on early access, underutilisation and quality of antenatal care services in Malawi: a retrospective study. Mchenga et al. BMC Health Services Research (2019) 19: 295 https://doi.org/10.1186/s12913-019-4130-1. |
| [24] | AFIDEP. (2016) Implications of new WHO antenatal guidelines on maternal mortality. |
| [25] | Weeks A, Temmerman M. (2016). New WHO antenatal care model—quality worth paying for? Lancet. 388: 2574–5. |
| [26] | Warri D. and George, A. (2020). Perceptions of pregnant women of reasons for late initiation of antenatal care: aqualitative interview study. BMC Pregnancy and Childbirth. 20: 70 https://doi.org/10.1186/s12884-020-2746-0. |
| [27] | Krejcie, R. V., & Morgan, D. W., (1970). Determining Sample Size for Research Activities. Educational and Psychological Measurement. |
| [28] | Siniscalco MT, Auriat N. (2005). Questionnaire design. In: Ross K, Quantitative research methods in educational planning. Paris. UNESCO. Google Scholar. |
| [29] | Myer L, Harrison A. (2003). Why do women seek antenatal care late? Perspectives from rural South Africa. J Midwifery Women’s Health. 48 (4): 268-272. PubMed | Google Scholar. |
| [30] | Halle Ekane GE et al. (2015b) Perceptions of antenatal care services by pregnant women attending government health centres in the Buea Health District, Cameroon: a cross sectional study. Pan African Medical Journal. 2015; 21: 45. [doi: 10.11604/pamj.2015.21.45.4858]. |
| [31] | Ebonwu J, Mumbauer A, Uys M, Wainberg ML, Medina-Marino A (2018). Determinants of late antenatal care presentation in rural and peri-urban communities in South Africa: A cross-sectional study. PLoS ONE 13 (3): e0191903. https://doi.org/10.1371/journal.pone.0191903. |
| [32] | Moungbakou, IBM. (2018). Commodification of care and its effects on maternal health in the Noun division (West Region – Cameroon) BMC Medical Ethics, 19 (Suppl 1): 43 https://doi.org/10.1186/s12910-018-0286-1. |
| [33] | Tolefac, PN; Halle-Ekane, GE; Agbor, VN; Sama, CB; Ngwasiri, C and Tebeu, PM (2017). Why do pregnant women present late for their first antenatal care consultation in Cameroon? Maternal Health, Neonatology, and Perinatology DOI 10.1186/s40748-017-0067-8. |
| [34] | UNICEF. (nd). Cameroon Country Programme 2018-2020 Strategy Note Cameroon Health Programme 2018-2020. http://files.unicef.org/transparency/documents/Cameroon_Strategy%20Note%20-%20Health%20-%20final%20sd.pdf. |
APA Style
Eyvonne Ngequih Tumasang, Robinson Mbu, Wilfred Mbacham. (2021). Cost Benefit Analysis of Four and Eight Antenatal Care Visits in Bamenda Health District, Cameroon. International Journal of Health Economics and Policy, 6(3), 79-84. https://doi.org/10.11648/j.hep.20210603.11
ACS Style
Eyvonne Ngequih Tumasang; Robinson Mbu; Wilfred Mbacham. Cost Benefit Analysis of Four and Eight Antenatal Care Visits in Bamenda Health District, Cameroon. Int. J. Health Econ. Policy 2021, 6(3), 79-84. doi: 10.11648/j.hep.20210603.11
AMA Style
Eyvonne Ngequih Tumasang, Robinson Mbu, Wilfred Mbacham. Cost Benefit Analysis of Four and Eight Antenatal Care Visits in Bamenda Health District, Cameroon. Int J Health Econ Policy. 2021;6(3):79-84. doi: 10.11648/j.hep.20210603.11
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.hep.20210603.11,
author = {Eyvonne Ngequih Tumasang and Robinson Mbu and Wilfred Mbacham},
title = {Cost Benefit Analysis of Four and Eight Antenatal Care Visits in Bamenda Health District, Cameroon},
journal = {International Journal of Health Economics and Policy},
volume = {6},
number = {3},
pages = {79-84},
doi = {10.11648/j.hep.20210603.11},
url = {https://doi.org/10.11648/j.hep.20210603.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.hep.20210603.11},
abstract = {Background: In 2016, the World Health Organization (WHO) published new antenatal care guidelines recommending an increase from four visits during pregnancy to eight contacts with skilled personnel, among other recommendations. Currently there are ongoing discussions in respect to the cost implications and potential outcomes countries can anticipate, if they make this move. Cameroon has adopted the new recommendation without analysis of the cost implication. Notwithstanding, it is imperative to investigate if pregnant women are willing to make this change, the cost implications of such changes, and if pregnant women will be willing to pay the extra cost. This study sets out to find out women’s preferred number of antenatal visits, their willingness to pay for antenatal visits and to perform a cost- benefit analysis of 4 and 8 visits in Bamenda Health District (BHD). Method: An exit interview was conducted using a semi structured interviewer administered questionnaire with women attending antenatal clinic in some 14 health facilities in BHD. The health facilities were chosen purposively. A total of 396 women were interviewed. Results: Our results revealed that 177 (44.7%) of the women preferred 4 antenatal care visits while 174 (43.9%) preferred 8 antenatal care visits and 45 (11.4%) preferred more than 8 antenatal visits. The extra cost for 4 and 8 visits was 10,390FCFA. The average willingness -to –pay (WTP) for 4 extra visits was calculated to be 2,209FCFA. Conclusion: Although women preferred a model of antenatal care (ANC) with 8 or more ANC contacts, they were not willing to pay for the contacts, thus it is recommended that the 4 visits model be implemented in the Bamenda Health District.},
year = {2021}
}
TY - JOUR T1 - Cost Benefit Analysis of Four and Eight Antenatal Care Visits in Bamenda Health District, Cameroon AU - Eyvonne Ngequih Tumasang AU - Robinson Mbu AU - Wilfred Mbacham Y1 - 2021/08/02 PY - 2021 N1 - https://doi.org/10.11648/j.hep.20210603.11 DO - 10.11648/j.hep.20210603.11 T2 - International Journal of Health Economics and Policy JF - International Journal of Health Economics and Policy JO - International Journal of Health Economics and Policy SP - 79 EP - 84 PB - Science Publishing Group SN - 2578-9309 UR - https://doi.org/10.11648/j.hep.20210603.11 AB - Background: In 2016, the World Health Organization (WHO) published new antenatal care guidelines recommending an increase from four visits during pregnancy to eight contacts with skilled personnel, among other recommendations. Currently there are ongoing discussions in respect to the cost implications and potential outcomes countries can anticipate, if they make this move. Cameroon has adopted the new recommendation without analysis of the cost implication. Notwithstanding, it is imperative to investigate if pregnant women are willing to make this change, the cost implications of such changes, and if pregnant women will be willing to pay the extra cost. This study sets out to find out women’s preferred number of antenatal visits, their willingness to pay for antenatal visits and to perform a cost- benefit analysis of 4 and 8 visits in Bamenda Health District (BHD). Method: An exit interview was conducted using a semi structured interviewer administered questionnaire with women attending antenatal clinic in some 14 health facilities in BHD. The health facilities were chosen purposively. A total of 396 women were interviewed. Results: Our results revealed that 177 (44.7%) of the women preferred 4 antenatal care visits while 174 (43.9%) preferred 8 antenatal care visits and 45 (11.4%) preferred more than 8 antenatal visits. The extra cost for 4 and 8 visits was 10,390FCFA. The average willingness -to –pay (WTP) for 4 extra visits was calculated to be 2,209FCFA. Conclusion: Although women preferred a model of antenatal care (ANC) with 8 or more ANC contacts, they were not willing to pay for the contacts, thus it is recommended that the 4 visits model be implemented in the Bamenda Health District. VL - 6 IS - 3 ER -
Information
Email: