Background: The cost of treating maternal complications has serious economic consequences to households and
can hinder the utilization of maternal health care services at the health facilities. This study estimated the cost of
maternal complications to women and their households in the Kassena-Nankana district of northern Ghana.
Methods: We carried out a cross-sectional study between February and April 2014 in the Kassena-Nankana district.
Out of a total of 296 women who were referred to the hospital for maternal complications from the health centre
level, sixty of them were involved in the study. Socio-demographic data of respondents as well as direct and
indirect costs involved in the management of the complications at the hospital were collected from the patient’s
perspective. Analysis was performed using STATA 11.
Results: Out of the 60 respondents, 60% (36) of them suffered complications due to prolonged labour, 17% (10)
due to severe abdominal pain, 10% (6) due to anaemia/malaria and 7% (4) due to pre-eclampsia. Most of the
women who had complications were primiparous and were between 21–25 years old. Transportation cost
accounted for the largest cost, representing 32% of total cost of treatment. The median direct medical cost was
US$8.68 per treatment, representing 44% of the total cost of treatment. Indirect costs accounted for the largest
proportion of total cost (79%). Overall, the median expenditure by households on both direct and indirect costs per
complication was US$32.03. Disaggregating costs by type of complication, costs ranged from a median of US$58.33
for pre-eclampsia to US$6.84 for haemorrrhage. The median number of days spent in the hospital was 2 days - five
days for pre-eclampsia. About 33% (6) of households spent more than 5% of annual household expenditure and
therefore faced catastrophic payments.
Conclusion: Although maternal health services are free in Ghana, women still incur substantial costs when
complications occur and face the risk of incurring catastrophic health expenditure.