Informal patient payments in maternity hospitals in Kiev, Ukraine

Authors

  • Tetiana Stepurko,

    Corresponding author
    1. School of Public Health, National University of ‘Kyiv-Mohyla Academy’, Kiev, Ukraine
    • Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
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  • Milena Pavlova,

    1. Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
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  • Olena Levenets,

    1. School of Public Health, National University of ‘Kyiv-Mohyla Academy’, Kiev, Ukraine
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  • Irena Gryga,

    1. School of Public Health, National University of ‘Kyiv-Mohyla Academy’, Kiev, Ukraine
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  • Wim Groot

    1. Department of Health Services Research, CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
    2. Top Institute for Evidence Based Education Research (TIER), Maastricht, Limburg, the Netherlands
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Correspondence to: T. Stepurko, School of Public Health, National University of “Kyiv-Mohyla Academy”, Kiev, Ukraine. E-mail: t.stepurko@maastrichtuniversity.nl

ABSTRACT

Maternity care in Ukraine is a government priority. However, it has not undergone substantial changes since the collapse of the Soviet Union. Similar to the entire health care sector in Ukraine, maternity care suffers from inefficient funding, which results in low quality and poor access to services. The objective of this paper is to explore the practice of informal payments for maternity care in Ukraine, specifically in cases of childbirth in Kiev maternity hospitals. The paper provides an ethnographic study on the consumers' and providers' experiences with informal payments. The results suggest that informal payments for childbirth are an established practice in Kiev maternity hospitals. The bargaining process between the pregnant woman (incl. her partner) and the obstetrician is an important part of the predelivery arrangement, including the informal payment. To deal with informal payments in Kiev maternity hospitals, there is a need for the following: (i) regulation of the “quasi-official” patient payments at the health care facility level; and (ii) improvement of professional ethics through staff training. These strategies should be coupled with improved governance of the health care sector in general, and maternity care in particular in order to attain international quality standards and adequate access to facilities. Copyright © 2012 John Wiley & Sons, Ltd.

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