Too expensive bringing newborns to hospital

Healthcare for new-borns is a political priority in Ethiopia. Nevertheless, essential care, such as treatment of new-borns, is currently financed through high patient fees.

For the poorest families, this means a terrible dilemma if one´s newborn becomes ill. They may have to sell a goat or a piece of land to be able to afford to take their child to a hospital.

“Many of the poorest are not able to mobilize enough money before it is too late, PhD-candidate Kristine Husøy Onarheim, at the Department of Global Public Health and Primary Care, University of Bergen (UiB).

She has just published in BMC Health Services Research.

Watch video of Onarheim´s presentation of her thesis here.

– Everything costs

Onarheim has followed and interviewed 22 different families, 10 health personnel as well as other people in a village south of Addis Ababa. She is investigating the  kind of dilemmas poor families face if it becomes necessary for them to have to consider taking their newborns to a hospital.

“One of the most important hindrances for the poor are the high fees. They have to pay for everything, every step of the process: from transport to diagnostics to treatment,” Onarheim explains.

Usually, poor families have to borrow money from other family members or friends, or they have to sell something. However, not everybody has something to sell or can find someone to borrow from, especially if one, one’s family and neighbours are among the poorest.

“If you are not able to mobilise money, it is not possible for you to bring your child to the hospital,” Onarheim points out.

Difficult choices

Onarheim is a member of the research group Global Healt Priorities at UiB. Health priorities is about prioritizing from a health budget. It is most often about giving advice to politicians and policy makers. One of the parts of her PHD-project, has been to focus on the grass root level of health priorities.

She has followed and interviewed families about the difficult choices they all must take in relation to balancing health and economy.

“The poor families are thrown into a very difficult situation with painful decisions. They have to balance the consideration for the sick child against the needs of the rest of the family and the daily responsibilities at home,” Onarheim says.

They might, for example, have four children at home that will not get food, if one uses all the money on medicines and medical treatment for one family member.

“It should not be acceptable that one has to choose between the health and survival of a newborn child and that of the well-being of the rest of the family,” Onarheim says.

– Free healthcare for newborns is the answer

According to Onarheim, the study shows that vital healthcare for newborns, such as treatment for infections or help with breathing, should be free. If this was the case, families would not be confronted with difficult choices and would bring sick infants to the hospital, even if they have no money.

“Studies show that mortality amongst new-borns are highest in the poorest families, where mothers have lowest degree of education and live in the furthest distance from hospitals. If one does not offer free health care for newborns, the mortality rate will not be reduced,” Kristine Husøy Onarheim says.