Cost Benefit Analysis of Four and Eight Antenatal Care Visits in Bamenda Health District, Cameroon

Background: In 2016, the World Health Organization (WHO) published new antenatal care guidelines recommending an increase from four visits during pregnancy to eight contacts with skilled personnel, among other recommendations. Currently there are ongoing discussions in respect to the cost implications and potential outcomes countries can anticipate, if they make this move. Cameroon has adopted the new recommendation without analysis of the cost implication. Notwithstanding, it is imperative to investigate if pregnant women are willing to make this change, the cost implications of such changes, and if pregnant women will be willing to pay the extra cost. This study sets out to find out women’s preferred number of antenatal visits, their willingness to pay for antenatal visits and to perform a cost- benefit analysis of 4 and 8 visits in Bamenda Health District (BHD). Method: An exit interview was conducted using a semi structured interviewer administered questionnaire with women attending antenatal clinic in some 14 health facilities in BHD. The health facilities were chosen purposively. A total of 396 women were interviewed. Results: Our results revealed that 177 (44.7%) of the women preferred 4 antenatal care visits while 174 (43.9%) preferred 8 antenatal care visits and 45 (11.4%) preferred more than 8 antenatal visits. The extra cost for 4 and 8 visits was 10,390FCFA. The average willingness -to –pay (WTP) for 4 extra visits was calculated to be 2,209FCFA. Conclusion: Although women preferred a model of antenatal care (ANC) with 8 or more ANC contacts, they were not willing to pay for the contacts, thus it is recommended that the 4 visits model be implemented in the Bamenda Health District.