Out-of-pocket expenses for Maternity Care in Rural Bangladesh: A Public – Private comparison

This paper examined out-of-pocket expenses incurred by women for availing maternal health care services at public and private health facilities. This article used data from a baseline household survey evaluating the impact of demand side financing vouchers on utilization and service delivery for maternal health care. The survey was conducted in 2010 among 3300 women who gave birth within previous 12 months from starting date of data collection. Information on costs incurred to receive antenatal, delivery and postnatal care services were collected. Findings reveal that the majority of women reported paying out-of-pocket expenses for availing maternal health care services both at public and private facilities. On average, women paid US$3.6 out-of-pocket expenses for receiving antenatal care at public health facilities and US$12.4 at private health facilities. Similarly, women paid one and half times more for normal (US$42.3) and cesarean deliveries (US$136.2) at private health facilities compared to public health facilities. On the other hand, costs for postnatal care did not vary significantly between public and private health facilities. Utilization of maternal care services can be improved if out-of-pocket expenses can be minimized.