Out of pocket payment for assisted reproductive techniques: How to households recover?

Simple item page
dc.contributor.advisorDyer, Silkeen_ZA
dc.contributor.authorVinoos, Latiefaen_ZA
dc.date.accessioned2018-02-13T08:33:42Z
dc.date.available2018-02-13T08:33:42Z
dc.date.issued2017en_ZA
dc.description.abstractIntroduction: The cost of ART remains amongst the most prevalent barriers to treatment, especially in resource limited countries where many people are poor and inadequately covered by private and public health insurances. This study aims to assess the financial consequences of out of pocket payment for ART in the South African setting and the ability of couples to financially recover. Methods: A prospective follow-up study was carried out at the Infertility Clinic of the Reproductive Medicine Unit, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town. All 135 participants from the original study were invited to participate with no exclusion criteria. A six part questionnaire, developed for the original study, was adjusted to assess recovery from out of pocket expenditure for ART. Indicators of recovery included the recuperation of savings, settlement of debt and reacquisition of sold assets. Persistence of coping strategies such as reduction in spending and additional work was also assessed. Results: A follow-up rate of 54% percent was achieved. The minimum and maximum follow up period was three and five years respectively. Nineteen percent of couples reported complete financial recovery, assessed as the recovery of savings, repayment of all debt and recovery of a sold asset. Forty percent of couples were unable to settle their debt incurred during the original study. The average amount still owed was R 7 750 (SD R5 140). At follow up, 75% of couples who had reduced expenditure to offset the original cost of ART were still reporting a reduction in expenditure while 39% were still engaged in additional work. The majority of couples reporting difficulties at the time of follow up in paying bills or for basic amenities and healthcare were from the poorest socioeconomic tertiles with 64% of all couples indicating that they were not coping financially at the time of follow up. Conclusion: This study documented a long-lasting impact of OPP for ART among all HH but especially among the poorest. Given the high prevalence of infertility, its impact on individuals, couples and communities, the associated mental, emotional and financial consequences, and existing barriers to adequate and affordable treatment should be minimised as South Africa is moving towards the implementation of a national health system.en_ZA
dc.identifier.apacitationVinoos, L. (2017). <i>Out of pocket payment for assisted reproductive techniques: How to households recover?</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology. Retrieved from http://hdl.handle.net/11427/27549en_ZA
dc.identifier.chicagocitationVinoos, Latiefa. <i>"Out of pocket payment for assisted reproductive techniques: How to households recover?."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology, 2017. http://hdl.handle.net/11427/27549en_ZA
dc.identifier.citationVinoos, L. 2017. Out of pocket payment for assisted reproductive techniques: How to households recover?. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Vinoos, Latiefa AB - Introduction: The cost of ART remains amongst the most prevalent barriers to treatment, especially in resource limited countries where many people are poor and inadequately covered by private and public health insurances. This study aims to assess the financial consequences of out of pocket payment for ART in the South African setting and the ability of couples to financially recover. Methods: A prospective follow-up study was carried out at the Infertility Clinic of the Reproductive Medicine Unit, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town. All 135 participants from the original study were invited to participate with no exclusion criteria. A six part questionnaire, developed for the original study, was adjusted to assess recovery from out of pocket expenditure for ART. Indicators of recovery included the recuperation of savings, settlement of debt and reacquisition of sold assets. Persistence of coping strategies such as reduction in spending and additional work was also assessed. Results: A follow-up rate of 54% percent was achieved. The minimum and maximum follow up period was three and five years respectively. Nineteen percent of couples reported complete financial recovery, assessed as the recovery of savings, repayment of all debt and recovery of a sold asset. Forty percent of couples were unable to settle their debt incurred during the original study. The average amount still owed was R 7 750 (SD R5 140). At follow up, 75% of couples who had reduced expenditure to offset the original cost of ART were still reporting a reduction in expenditure while 39% were still engaged in additional work. The majority of couples reporting difficulties at the time of follow up in paying bills or for basic amenities and healthcare were from the poorest socioeconomic tertiles with 64% of all couples indicating that they were not coping financially at the time of follow up. Conclusion: This study documented a long-lasting impact of OPP for ART among all HH but especially among the poorest. Given the high prevalence of infertility, its impact on individuals, couples and communities, the associated mental, emotional and financial consequences, and existing barriers to adequate and affordable treatment should be minimised as South Africa is moving towards the implementation of a national health system. DA - 2017 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - Out of pocket payment for assisted reproductive techniques: How to households recover? TI - Out of pocket payment for assisted reproductive techniques: How to households recover? UR - http://hdl.handle.net/11427/27549 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/27549
dc.identifier.vancouvercitationVinoos L. Out of pocket payment for assisted reproductive techniques: How to households recover?. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology, 2017 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/27549en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Obstetrics and Gynaecologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherObstetrics and Gynaecologyen_ZA
dc.subject.otherHealth Economicsen_ZA
dc.titleOut of pocket payment for assisted reproductive techniques: How to households recover?en_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
thesis_hsf_2017_vinoos_latiefa.pdf
Size:
1.68 MB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Masters