The immediate economic impact of maternal deaths on rural Chinese households

Abstract

Objective: To identify the immediate economic impact of maternal death on rural Chinese households.

Methods: Results are reported from a study that matched 195 households who had suffered a maternal death to 384 households that experienced a childbirth without maternal death in rural areas of three provinces in China, using quantitative questionnaire to compare differences of direct and indirect costs between two groups.

Findings: The direct costs of a maternal death were significantly higher than the costs of a childbirth without a maternal death (US$4,119 vs. $370, p<0.001). More than 40% of the direct costs were attributed to funeral expenses. Hospitalization and emergency care expenses were the largest proportion of non-funeral direct costs and were higher in households with maternal death than the comparison group (US$2,248 vs. $305, p<0.001). To cover most of the high direct costs, 44.1% of affected households utilized compensation from hospitals, and the rest affected households (55.9%) utilized borrowing money or taking loans as major source of money to offset direct costs. The median economic burden of the direct (and non-reimbursed) costs of a maternal death was quite high--37.0% of the household's annual income, which was approximately 4 times as high as the threshold for an expense being considered catastrophic.

Conclusion: The immediate direct costs of maternal deaths are extremely catastrophic for the rural Chinese households in three provinces studied.

Figure 1. Non-funeral direct costs for households with maternal death.

Note: costs presented here are sub-group analysis based on the affected group (n = 195); 48 cases were missing in category of delivery type (48 women in affected group died before childbirth and no delivery type was concerned); 74 cases were missing in category of whether the newborn received emergency treatment(48 women in affected group died before childbirth, 24 cases were stillbirths, and 2 cases were unknown); 78 cases were missing in category of whether the newborn was specially treated in hospital (48 women in affected group died before childbirth, 24 cases were stillbirths, and 6 cases were unknown).