The Nepal Safer Motherhood Project (NSMP), funded by the Department for International Development (DFID) and managed by Options, aims to support the National Safe Motherhood (SM) Programme of His Majesty’s Government of Nepal (HMGN) by helping to improve service provision and increase access to core services. While there is growing evidence that costs are a major barrier to women seeking essential maternity services, few studies on the extent, content and impact of these costs have been carried out. This study examines costs from a variety of perspectives. A survey of women recently delivered at home and in health facilities was carried out to obtain information on household costs and maternal health seeking behaviour. In addition, a willingness-to-pay (WTP) study was used to investigate women’s preferences for, and valuation of, alternative delivery care services. These household based studies were supported by a facility study to investigate user charge and exemption policies in facilities, plus a study of the costs of providing delivery care in one zonal hospital. Finally, options for addressing the issue of high cost were investigated by looking at international evidence on maternal care financing and existing Nepalese financing schemes.
Borghi, J.; Ensor, T.; Neupane, B.D.; Tiwari, S. Coping with the Burden of the Costs of Maternal Health. (2004) 137 pp.