Constraints faced by hospitalized maternity patients in Niamey (Niger)

A cross-sectional survey was conducted in the main maternity hospital in Niamey (Maternité Poudrière) in July 1995 to evaluate the domestic and financial pressures faced by the patients. One-hundred-and-five women were included in this exhaustive survey which analyzed the socio-demographic characteristics of the patients' households, the reasons for their hospitalization, the organization of their daily life while in hospital, and the costs involved (type of costs, the amounts, and who paid which cost). Fifty-seven women lived in Niamey, and forty-eight in a rural area. The socio-demographic characteristics of the survey population were in agreement with the characteristics of Niger's census in 1988. Analysis of the patients' incomes showed that they were highly dependent on their husbands. Fifty-eight received surgical treatment, and forty-seven received medical treatment. The costs of hospitalization included the standard fee, traveling expenses, and the costs of drugs and surgery. On average, 72% of the hospitalization costs were paid by the husbands, and 15% by close members of the family. The contribution by extended family members and friends was very small. Only 40.5% of the total amounts exceeding 25,000 FCFA were wholly paid. Niger has a policy of recovering medical costs. Our survey shows the difficulties of attempting to reconcile the operation of health centers with access to specialist care.