Out-of-Pocket Expenditure on Delivery Care in Public and Private Health Sectors – A Study in a Rural District of Pakistan

Keywords: Delivery care, out-of-pocket expenditure, public health sector, private health sector, Pakistan.


Pakistan witnessed a significant improvement in maternal health outcomes during the past two decades. However, persistent urban-rural and socio-economic inequalities exist in access to maternal healthcare services across the country. The objective of this study was to estimate out-of-pocket expenditure (OOPE) on delivery care by women in the public and private health sectors in RajanPur district. This was a cross-sectional study conducted, among 368 randomly selected mothers who had childbirths from 1st October to 31st December 2020. The study applied multi-stage random sampling technique to select the study participants. The results showed that about two-thirds of mothers preferred public hospitals for most recent delivery. The percentage of cesarean deliveries conducted in private hospitals (43.8%) was 4.7 times higher than in public hospitals (9.3%). About 99% of mothers incurred OOPE during delivery care, and the mean OOPE incurred during delivery care was PKR 2840 (US$ 17.75) in public hospitals and PKR 25596 (US$159.9) in private hospitals. OOPE on cesarean delivery in private hospitals (PKR 39654.7, US$247.8) was 2.5 times higher than the public hospitals (PKR16111.9, US$100.69), whereas OOPE incurred on normal delivery care in private hospitals (PKR14339, US$89.62) was 9.5 times higher than OOPE in public hospitals(PKR 1501.4, US$9.38).To conclude, the findings and recommendations drawn from the research would provide some insights to health policymakers and planners in developing an integrated and viable maternal healthcare program in Pakistan.


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Author Biographies

Sohail Akhtar, Qassim University, Saudi Arabia.

Faculty of Medicine and Health Sciences UNIMAS, Universiti Malaysia Sarawak, Malaysia. Department of Health Informatics, College of Public Health and Health Informatics, Qassim University, Saudi Arabia.

Zafar Ahmed, Universiti Malaysia Sarawak, Malaysia.

Faculty of Medicine and Health Sciences UNIMAS, Universiti Malaysia Sarawak, Malaysia.

Kesavan Sreekantan Nair, Qassim University, Saudi Arabia.

Department of Health Administration, College of Public Health and Health Informatics, Qassim University, Saudi Arabia.

Yasir Hayat Mughal, Qassim University, Saudi Arabia.

Department of Health Administration, College of Public Health and Health Informatics, Qassim University, Saudi Arabia.

Asim Mehmood, Jazan University, Saudi Arabia.

Department of Health Informatics, Faculty of Public Health and Tropical Medicine, Jazan University, Saudi Arabia.


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How to Cite
Akhtar, S., Ahmed, Z., Nair, K. S., Mughal, Y. H., & Mehmood, A. (2022). Out-of-Pocket Expenditure on Delivery Care in Public and Private Health Sectors – A Study in a Rural District of Pakistan. Amazonia Investiga, 11(54), 121-136. https://doi.org/10.34069/AI/2022.54.06.12