• Puja Gartaula, Shristi Neupane, Dip Narayan Thakur, and Raj Kumar Sangroula.
• Department of Public Health, Little Buddha College of Health Sciences, New Baneshwar, Kathmandu, Nepal.
• JNMA J Nepal Med Assoc. 2020 Dec 31; 58 (232): 1024-1027.

IntroductionInstitutional delivery in Nepal is increasing in the past decades and has been the priority program of the government of Nepal. However, due to the hidden costs related to institutional deliveries, the financial burden remains unacceptably high for poor households. The study aimed to find out the major out of pocket expenditure on health service delivery at a tertiary care hospital in Kathmandu, Nepal.MethodsA descriptive cross-sectional study was carried out at a tertiary care hospital from December 2018 to May 2019. Ethical approval was taken from Nepal Health Research Council (ref. no. 2087) and permission was taken from the hospital. Informed consent was taken from the participants. Convenient sampling was done. A semi-structured questionnaire was used as a tool for the interview. Data was entered into Epidata and analyzed using the Statistical Package of the Social Sciences version 23. Descriptive analysis was done using mean, median, standard deviation, inter-quartile range, frequency, and percentage.ResultsThe median out of pocket expenditure of the participants to maternal delivery was NRs. 11720 (7610-20263). The median expenditure was found highest for food and drinking NRs. 2500 (1500-5550) and transportation NRs. 2150 (1400-4543) respectively.ConclusionsIndirect expenditures were found to be higher than direct medical expenditures. Accessibility of the birthing centers and health insurance may reduce the costs related to maternal deliveries.

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