Factors influencing the access of waivers and exemptions for health commodities among pregnant women in public health facilities in Ubungo Municipal Council, Tanzania

Abstract

To improve maternal health care to all pregnant women, Tanzania is implementing the waivers and exemptions on maternal healthcare services. There are various interventions in Dar es Salaam Region which is home to about 10 percent of Tanzania’s population. Yet, maternal mortality is still high in Dar es Salaam Region. Literature shows that there is no any study that has been conducted focused on accessibility of waivers and exemptions for health commodities among pregnant women in public health facilities in Ubungo Municipal Council. Therefore, this study aimed at exploring factors influencing the access of waivers and exemptions for health commodities among pregnant women in public health facilities in Ubungo Municipal Council, Tanzania. This study was guided by Social-Ecological Model employing mainly qualitative methodology with descriptive design to pregnant women attending maternal health care clinics and healthcare providers providing maternal health care at the selected health facilities. Purposeful sampling strategy was adopted to gather study participants. In-depth interviews and focus group discussions were conducted to gather data, which was then analyzed thematically. The WHO method to construct commodity availability indices approach was used during analysis of data collected through direct observation using SPSS. No harm came from this study, as ethical issues were considered.

Results of the study show that almost all of the visited public health facilities have exempted essential equipment and supplies for maternal pregnant women. The results of the study also found that economic status of the pregnant women, fear of stigma and discrimination, perceived quality of maternal health services, decision making autonomy, presence or absence of complication during pregnancy, perceived difficulties in digesting iron tablets, health literacy on maternal health, availability of maternal health commodities, availability of waiting area, availability of budget for maternal health commodities, accessibility of health facilities, availability of service providers, exemption mechanisms for maternal health commodities, and availability of maternal commodities in the MSD are factors influencing access of maternal health commodities among pregnant women in public health facilities. The study recommends that the government should ensure v intervention strategies to promote maternal health literacy, social mobilization efforts to reduce stigma and discrimination, availability of maternal health commodities and health staff, accessibility of public health facilities, and improve socioeconomic status of the pregnant women to improve access of exempted maternal health commodities in public health facilities. To do this, the government should ensure there is enough budget allocated for maternal healthcare and employ adequate health workers in public health facilities. Also, road infrastructures to the health facilities should be improved for easy access to health facilities.