title: Household coping strategies for delivery and related healthcare cost: findings from rural Bangladesh.
abstract: OBJECTIVE
  This study aims to measure the economic costs of maternal complication and to understand household coping strategies for financing maternal healthcare cost.
  
  
  METHODS
  A household survey of the 706 women with maternal complication, of whom 483 had normal delivery, was conducted to collect data at 6 weeks and 6 months post-partum. Data were collected on socio-economic information of the household, expenditure during delivery and post-partum, coping strategies adopted by households and other related information.
  
  
  RESULTS
  Despite the high cost of health care associated with maternal complications, the majority of families were capable of protecting consumption on non-health items. Around one-third of households spent more than 20% of their annual household expenditure on maternal health care. Almost 50% were able to avoid catastrophic spending because of the coping strategies that they relied on. In general, households appeared resilient to short-term economic consequences of maternal health shocks, due to the availability of informal credit, donations from relatives and selling assets. While richer households fund a greater portion of the cost of maternal health care from income and savings, the poorer households with severe maternal complication resorted to borrowing from local moneylenders at high interest, which may leave them vulnerable to financial difficulties.
  
  
  CONCLUSIONS
  Financial protection, especially for the poor, may benefit households against economic consequences of maternal complication.
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Qld, Australia.|International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh.
authors.forename: Mohammad Enamul
authors.initials: ME
authors.lastname: Hoque
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh.
authors.forename: Sushil Kanta
authors.initials: SK
authors.lastname: Dasgupta
authors.affiliation: Campaign for Tobacco Free Kids, Dhaka, Bangladesh.
authors.forename: Eva
authors.initials: E
authors.lastname: Naznin
authors.affiliation: School of Public Health, University of Queensland, Brisbane, Qld, Australia.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al Mamun
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001459:Bangladesh; D005260:Female; D005102:Health Expenditures; D006801:Humans; D000068097:Maternal Health / Q000191:economics*; D008427:Maternal Health Services / Q000191:economics*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000191:economics*; D012423:Rural Health / Q000191:economics*; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Bangladesh; catastrophic payments; coping strategies; estrategias de afrontamiento; maternal health; pagos catastróficos; paiements catastrophiques; salud materna; santé maternelle; stratégies d'adaptation