Out-of-pocket payment for assisted reproductive techniques in the public health sector in South Africa - how do households cope?
In South Africa assisted reproductive techniques (ART) are poorly covered by health insurances or government funding thereby often inflicting out-of-pocket payment (OPP) on patients. This can create treatment barriers or high financial burdens for households, with unknown consequences of the latter. This is the first study from South and sub-saharan Africa which explores the impact of ART-related OPP on households. The study was undertaken at Groote Schuur Hospital, Cape Town, where ART is subsidized but patients have to contribute to the cost of treatment. Eighty six consecutive IVF/ICS/ cycles were prospectively analysed through patient interviews. Data included socio-demographic, economic, and infertility information, emotional and financial stress among participants, as well as coping and financial strategies adopted by households. In keeping with international recommendations, catastrophic expenditure was defined as a direct cost of all ART cycles in the last 12 months equal to or exceeding 40% of the annual non-food households expenditure.
Networked Digital Library of Theses and Dissertations
Department of Obstetrics and Gynaecology