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Beyond coverage: a qualitative study exploring the perceived impact of Gabon’s health insurance plan on access to and quality of prenatal care
BACKGROUND: Access to affordable and adequate healthcare in a health system determines the universal health coverage achievement for all residents in a country. Achieving access to healthcare requires the availability of a financing system that ensures access to and provision of adequate care, regar...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260761/ https://www.ncbi.nlm.nih.gov/pubmed/32473629 http://dx.doi.org/10.1186/s12913-020-05310-6 |
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author | Sanogo, N’doh Ashken Fantaye, Arone Wondwossen Yaya, Sanni |
author_facet | Sanogo, N’doh Ashken Fantaye, Arone Wondwossen Yaya, Sanni |
author_sort | Sanogo, N’doh Ashken |
collection | PubMed |
description | BACKGROUND: Access to affordable and adequate healthcare in a health system determines the universal health coverage achievement for all residents in a country. Achieving access to healthcare requires the availability of a financing system that ensures access to and provision of adequate care, regardless of the ability to pay. In sub-Saharan Africa, accessibility, use and coverage of prenatal visits are very low and poor, which reduces the quality of care. This paper explored the impact of a social health insurance scheme on the quality of antenatal care in Gabon. METHODS: This qualitative study involved the analysis of data collected from semi-structured interviews and non-participant observations to assess the quality of antenatal care. The study elicited perceptions on the demand side (pregnant women) and the supply side (health professionals) in health facilities. Fifteen semi-structured interviews were conducted with pregnant women (aged between 15 and 49) and 5 with health professionals, who each had a seniority of at least 10 years, at different levels of care. Nine non-participant observations were also conducted. Coded transcripts were reviewed and analyzed using the Canadian Institute for Public Administration of Citizen-Centered Services model as an analytical guide. RESULTS: On the demand side, women were generally satisfied with the prenatal services they receive in health facilities. However, complaints were made about the rudeness of some nurses, the high price of the delivery kit (50,000 XAF), and the fact that some essential medicines for maternity are not covered. On the supply side, participants agreed that compulsory health insurance is important in providing antenatal care access to those who need it the most. However, some problems remain. The participants outlined some logistical problems and a lack of medical equipment, including the stock of drugs, disinfectants, and the absence of clean water. CONCLUSION: Understanding the perceptions of pregnant women and health professionals regarding the quality of antenatal care can help to inform refinements to methods through which the services can be better provided. In addition, the study findings are vital to increasing the use of care, as well as combating high maternal mortality rates. Compulsory health insurance has improved the accessibility and utilization of healthcare services and has contributed to improved quality of care. |
format | Online Article Text |
id | pubmed-7260761 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72607612020-06-07 Beyond coverage: a qualitative study exploring the perceived impact of Gabon’s health insurance plan on access to and quality of prenatal care Sanogo, N’doh Ashken Fantaye, Arone Wondwossen Yaya, Sanni BMC Health Serv Res Research Article BACKGROUND: Access to affordable and adequate healthcare in a health system determines the universal health coverage achievement for all residents in a country. Achieving access to healthcare requires the availability of a financing system that ensures access to and provision of adequate care, regardless of the ability to pay. In sub-Saharan Africa, accessibility, use and coverage of prenatal visits are very low and poor, which reduces the quality of care. This paper explored the impact of a social health insurance scheme on the quality of antenatal care in Gabon. METHODS: This qualitative study involved the analysis of data collected from semi-structured interviews and non-participant observations to assess the quality of antenatal care. The study elicited perceptions on the demand side (pregnant women) and the supply side (health professionals) in health facilities. Fifteen semi-structured interviews were conducted with pregnant women (aged between 15 and 49) and 5 with health professionals, who each had a seniority of at least 10 years, at different levels of care. Nine non-participant observations were also conducted. Coded transcripts were reviewed and analyzed using the Canadian Institute for Public Administration of Citizen-Centered Services model as an analytical guide. RESULTS: On the demand side, women were generally satisfied with the prenatal services they receive in health facilities. However, complaints were made about the rudeness of some nurses, the high price of the delivery kit (50,000 XAF), and the fact that some essential medicines for maternity are not covered. On the supply side, participants agreed that compulsory health insurance is important in providing antenatal care access to those who need it the most. However, some problems remain. The participants outlined some logistical problems and a lack of medical equipment, including the stock of drugs, disinfectants, and the absence of clean water. CONCLUSION: Understanding the perceptions of pregnant women and health professionals regarding the quality of antenatal care can help to inform refinements to methods through which the services can be better provided. In addition, the study findings are vital to increasing the use of care, as well as combating high maternal mortality rates. Compulsory health insurance has improved the accessibility and utilization of healthcare services and has contributed to improved quality of care. BioMed Central 2020-05-30 /pmc/articles/PMC7260761/ /pubmed/32473629 http://dx.doi.org/10.1186/s12913-020-05310-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Sanogo, N’doh Ashken Fantaye, Arone Wondwossen Yaya, Sanni Beyond coverage: a qualitative study exploring the perceived impact of Gabon’s health insurance plan on access to and quality of prenatal care |
title | Beyond coverage: a qualitative study exploring the perceived impact of Gabon’s health insurance plan on access to and quality of prenatal care |
title_full | Beyond coverage: a qualitative study exploring the perceived impact of Gabon’s health insurance plan on access to and quality of prenatal care |
title_fullStr | Beyond coverage: a qualitative study exploring the perceived impact of Gabon’s health insurance plan on access to and quality of prenatal care |
title_full_unstemmed | Beyond coverage: a qualitative study exploring the perceived impact of Gabon’s health insurance plan on access to and quality of prenatal care |
title_short | Beyond coverage: a qualitative study exploring the perceived impact of Gabon’s health insurance plan on access to and quality of prenatal care |
title_sort | beyond coverage: a qualitative study exploring the perceived impact of gabon’s health insurance plan on access to and quality of prenatal care |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260761/ https://www.ncbi.nlm.nih.gov/pubmed/32473629 http://dx.doi.org/10.1186/s12913-020-05310-6 |
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