The Dean, School of Economics, College of Business and Management Sciences (CoBAMS), Makerere University invites you to a Viva Voce examination of Ms. Phiona Atuhaire.
Title of Thesis: “Healthcare financing, maternal health outcomes and inequalities in maternal healthcare utilisation in Uganda: implications for achieving universal health coverage”.
Date and Time: Monday 2nd October, 2023 at 9:00 AM to 12:00 PM EAT.
Supervisors
Dr, Elizabeth Ekirapa-Kiracho, Associate Professor, Makerere University, School of Public Health.
Dr. John Mutenyo, Senior Lecturer, School of Economics, CoBAMS, Makerere University.
Join Zoom Meeting
https://zoom.us/j/98473524243?pwd=amlBN2pxUWt5S3JWVWE1VjhINFZiUT09
Meeting ID: 984 7352 4243
Passcode: 330754
Abstract
Maternal mortality rate in Uganda of 343 remains far above the national target of 211 per 100,000 live births. Increasing healthcare expenditure and reducing inequalities in utilisation of maternal health services are key in addressing the high rate of maternal mortality. However, little is known about the effect of current health expenditure on maternal mortality, and the nature and trend of inequalities in utilisation of maternal health services in Uganda.
Time series data from the World Development Indicators for the period 1995-2019 were used to explore the effect of healthcare expenditure on maternal mortality ratio using an auto-regressive distributed lag model. The Uganda Demographic Health Survey data for 2006, 2011 and 2016 were used to analyse inequalities in utilisation of antenatal care, skilled birth attendance, postnatal care and a continuum of care. Equity ratios, concentration indices and regressions were used to estimate the inequalities.
Findings showed that domestic government expenditure on maternal health conditions is associated with a decline in maternal mortality over the long run. Inequalities in utilization of single and a continuum of maternal health services reduced between 2006 and 2016 but remained pro-rich. Women from the richest quintile were 4 times more likely to receive a continuum of care compared to the poorest women but were just 1.5 times more likely to receive four or more antenatal care visits (ANC4+) than those in the poorest quintile. Women with higher education and living in urban areas were also more likely to utilise maternal healthcare services.
Government should increase domestic expenditure on maternal health to reduce maternal mortality. Targeted interventions such as voucher schemes, free birth kits for poorer and rural women should be implemented to improve utilisation of maternal health services for the poor and those in rural areas to address the existing inequalities. The combined intervention of increasing health care expenditure on maternal health and reducing socio-economic inequalities is necessary for Uganda to achieve universal health coverage.