Informal patient payments in maternity hospitals in Kiev, Ukraine

Tetiana Stepurko*, Milena Pavlova, Olena Levenets, Irena Gryga, Wim Groot

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

22 Citations (Web of Science)


Maternity care in Ukraine is a government priority. However, it has not undergone substantial changes since the collapse of the Soviet Union. Similar to the entire health care sector in Ukraine, maternity care suffers from inefficient funding, which results in low quality and poor access to services. The objective of this paper is to explore the practice of informal payments for maternity care in Ukraine, specifically in cases of childbirth in Kiev maternity hospitals. The paper provides an ethnographic study on the consumers' and providers' experiences with informal payments. The results suggest that informal payments for childbirth are an established practice in Kiev maternity hospitals. The bargaining process between the pregnant woman (incl. her partner) and the obstetrician is an important part of the predelivery arrangement, including the informal payment. To deal with informal payments in Kiev maternity hospitals, there is a need for the following: (i) regulation of the "quasi-official" patient payments at the health care facility level; and (ii) improvement of professional ethics through staff training. These strategies should be coupled with improved governance of the health care sector in general, and maternity care in particular in order to attain international quality standards and adequate access to facilities.

Original languageEnglish
Pages (from-to)e169-e187
Number of pages19
JournalInternational Journal of Health Planning and Management
Issue number2
Early online date13 Dec 2012
Publication statusPublished - 4 Jun 2013


  • Anthropology, Cultural
  • Female
  • Financing, Personal
  • Health Services Accessibility
  • Hospitals, Maternity
  • Humans
  • Male
  • Medical Staff, Hospital
  • Negotiating
  • Patient Credit and Collection
  • Physician-Patient Relations
  • Pregnancy
  • Qualitative Research
  • Quality Indicators, Health Care
  • Ukraine
  • maternity care
  • childbirth
  • health care services
  • informal payments

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