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When things fall apart: local responses to the reintroduction of user-fees for maternal health services in rural Malawi

Reproductive health matters, November 2018, Vol.26(54), pp.126-136 [Peer Reviewed Journal]

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  • Title:
    When things fall apart: local responses to the reintroduction of user-fees for maternal health services in rural Malawi
  • Author: Pot, Hanneke ; De Kok, Bregje C ; Finyiza, Gertrude
  • Found In: Reproductive health matters, November 2018, Vol.26(54), pp.126-136 [Peer Reviewed Journal]
  • Subjects: Accountability ; Health Systems ; Home-Birth Fines ; Inequity Malawi ; Maternal Health Policy ; Power ; Traveling Models ; User-Fees ; Fee-for-Service Plans ; Health Care Costs ; Health Policy -- Economics ; Healthcare Disparities -- Economics ; Maternal Health Services -- Economics
  • Language: English
  • Description: Despite the strong global focus on improving maternal health during past decades, there is still a long way to go to ensure equitable access to services and quality of care for women and girls around the world. To understand widely acknowledged inequities and policy-to-practice gaps in maternal health, we must critically analyse the workings of power in policy and health systems. This paper analyses power dynamics at play in the implementation of maternal health policies in rural Malawi, a country with one of the world's highest burdens of maternal mortality. Specifically, we analyse Malawi's recent experience with the temporary reintroduction of user-fees for maternity services as a response to the suspension of donor funding, a shift in political leadership and priorities, and unstable service contracts between the government and its implementing partner, the Christian Health Association of Malawi. Based on ethnographic research conducted in 2015/16, the article describes the perceptions...
  • Identifier: E-ISSN: 1460-9576 ; PMID: 30388957 Version:1 ; DOI: 10.1080/09688080.2018.1535688

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