Financing maternal healthcare in the context of free healthcare

Introduction: In Côte d’Ivoire, a strategy of waiving user fees for maternal health services in public facilities has been adopted to remove the financial barrier to accessing care. The aim of our study was to evaluate free maternal health care from the point of view of households. Methods: From May to July 2022, we conducted a descriptive cross-sectional study of mothers selected by systematic sampling with an infant under one year of age.Results: A total of 486 mothers with an average age of 29.63 6.59 years. Nearly 3 out of 10 women had no schooling, and 42% had an income-generating activity. Over 90% of out-of-pocket payments were for caesarean sections (50/50), ultrasound (377/384), drugs (360/384) and laboratory (344/384). The most expensive item was hospitalization, with an average of 149395.60 32497.35 FCFA, followed by Caesarean section with 140600 59776 .99 FCFA.Conclusion: Fee exemption is not effective in maternal health services. The unavailability of certain services is an obstacle to the implementation of this provision.