Abstract:
Background: Since 2005, the Ethiopian health care system has encouraged free maternity health
care service to increase access to maternity care by women of different socioeconomic statuses.
As well as to increase the number of women seeking maternity services like institutional delivery
by eliminating the financial barriers among pregnant women. Even though maternity service is
free of charge. The hidden cost has unquestionably been a key obstacle in seeking and utilizing
health care services. Significant payments due to delivery services could create a heavy
economic burden on households.
Objectives: To determine hidden cost of hospital-based delivery and associated factors among
postpartum women attending public hospitals in Gamo zone, southern Ethiopia 2023.
Methods and Materials: Facility-based cross-sectional study was conducted on 411 postpartum
women in Gamo Zone Public Health Hospitals from December 01, 2022 to January 30, 2023.
Systematic random sampling technique was applied to reach study units. Data was collected by
using kobo tool box data collection tool and exported to SPSS statistical software version 27 for
analysis. Simple linear regression and multiple linear regressions were done to see association of
variables. The significance level was declared at P-value < 0.05 in the final model.
Result: The median hidden cost of hospital-based delivery was 1142 Ethiopian birr (ETB) with
range of 2262 ETB. Monthly income of the family (β=0.019), obstetrics complications
(β=0.033), distance from the health facility (β=0.003), mode of delivery (β=0.072), were
positively associated with the hidden cost of hospital-based delivery. While, rural residence (β =
-0.041) was negatively associated with the outcome variable.
Conclusion and recommendation: This study showed hidden cost of hospital based delivery
was high. Residence, monthly income of family, obstetrics complication, mode of delivery and
distance from health facility was statically significant. These factors should be considered in
health intervention program and hospitals should be ensuring the availability of essential drugs and other medical supplies in the health facilit
