Choice of Delivery Facility among Expectant Mothers in Ghana

Abstract

This article examines the effect of health insurance ownership among expectant mothers on facility-based delivery, having controlled for a host of socio-economic and demographic characteristics. Home deliveries often endanger the health of women, where complications are often referred to appropriate health facilities only when the condition has already deteriorated. Consequently, this study examines the extent to which expectant mothers’ access to health insurance influence their choice of delivery facilities broadly categorized into public health facilities, private health facilities and home delivery. Methodologically, the multinomial logistic regression is employed in the empirical estimation. Using the 2008 Ghana Demographic and Health Survey, we found at both the bivariate and multivariate level that women with access to health insurance are more likely to deliver in modern health facilities namely public and private allopathic health facilities relative to home delivery. In particular, women with access to health insurance are approximately 18 percentage points more likely to deliver in a public health facility as compared to home delivery. Also, the propensity to deliver in private health facilities relative to home delivery increases by one percentage point for women with health insurance. Thus, for expectant mothers with health insurance, the utilization of public health facilities predominates. Some of the control variables that were found to significantly influence the choice of delivery facilities include age, educational attainment, wealth quintile, area of residence, religion and region of residence. The study makes a case for scaling up access to health insurance among expectant mothers due to its positive effect on the choice of appropriate delivery facilities.

They receive antenatal care in health facilities, yet do not deliver there: predictors of health facility delivery by women in rural Ghana

“…In this study, having a valid health insurance was associated with health facility delivery. This finding supports the findings of another study in Ghana that reported high utilization of health facility delivery with the possession of a health insurance [ 37 ].…”

Ghana's national health insurance, free maternal healthcare and facility‐based delivery services

“…While about 72.16% of insured women were delivered at facilities, only 50.93% of the uninsured mothers were delivered at facilities ( p < .001). In a similar study, Nketiah‐Amponsah and Arthur (2013) found significant association between insurance ownership and place of delivery. Similarly, before the FMH policy, only 40.04% of women were registered with the NHIS while 70.34% registered after the policy ( p < .001).…”

“…A fight considered one of the strongest indicators of economic development (Oyekale, 2014). There is substantial evidence of the positive effects of health insurance on the utilization of maternal healthcare (Comfort, Peterson, & Hatt, 2013; Frimpong et al, 2014; Nketiah‐Amponsah & Arthur, 2013; Wang, Temsah, & Mallick, 2017; Yaya, Da, Wang, Tang, & Ghose, 2019). Ghana implemented the NHIS in 2005 (NHIA, 2010) and introduced an FMH programme into the scheme in July 2008.…”

Determinant factors of home delivery among women in Northern Ethiopia: a case control study

“…Studies from Kathmandu, Nepal, and Malawi showed a strong connection between no/fewer than four ANC visits and home delivery [9, 20]. Studies in Ghana’s well as North Showa, Dabat, East Wollega, and Sekela District and Munisa Districts in Ethiopia showed that women who had more prenatal visits were more likely to deliver at the health institutions [16, 17, 19, 21–23] Failing to capitalize on ANC visits could be significant missed opportunity in the FMoH’s efforts to reduce maternal mortality and morbidity.…”