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

Agbanyo, Richard

doi:10.1111/1467-8268.12412

Cited by 31 publications

(30 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Consequently, higher health services utilization in rural locations is not always a function of improved healthcare delivery system but a reflection of lack of choice for better alternatives. Indeed, other barriers to MNCH service utilization not explored in this study are acknowledged in terms of long travel times to health facilities [24,26,29], socio-cultural beliefs [16,23,30,31] and financial inaccessibility [32][33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Trends and correlates of maternal, newborn and child health services utilization in primary healthcare facilities: an explorative ecological study using DHIMSII data from one district in the Volta region of Ghana

Alhassan

Owusu‐Agyei

Ansah

et al. 2020

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background Sustainable Development Goal 3 aims at reducing global neonatal mortality to at least 12 per 1000 livebirths, under-five mortality to at least 25 per 1000 livebirths and maternal mortality ratio to less than 70 per 100,000 livebirths by 2030. Considering the achievement so far, many countries in sub-Saharan Africa, including Ghana are not likely to achieve these targets. Low utilization of maternal, newborn and child health (MNCH) services partly account for this predicament. This study explored the trend and correlates of MNCH services utilization in one administrative district in the Volta Region of Ghana. Methods This is an explorative ecological study employing trend analysis of 2015–2017 data from Ghana Health Service District Health Information Management System II. Univariate Poisson regression models were used to determine the factors associated with MNCH services utilization at 95% confidence level. Results Cumulative record of 17,052 antenatal care (ANC) attendance and 2162 facility-based spontaneous vaginal deliveries (SVDs) was discovered. Compelling evidence of potential unskilled deliveries was observed in 23% of the 26 facilities reported in the DHIMSII data. High cumulative number of midwives in health facilities associated positively with high records of ANC visits (IRR = 1.30, [95% CI:1.29, 1.32]; p = 0.0001), facility-based SVDs (IRR = 1.30 [95% CI:1.25, 1.35]; p = 0.0001) and BCG immunizations (IRR = 1.32 [95% CI:1.29, 1.34]; p = 0.0001). Likewise, high records of ANC visits correlated positively with high facility-based SVDs and child immunizations records (p < 0.0001). Conclusion Targeted health system and community level interventions alongside progressive frontline health staff motivation and retention strategies could further enhance enrollment and retention of mothers in pre-natal and postnatal care services throughout the continuum of care to guarantee better MNCH health outcomes. Investments in universal coverage for quality ANC services has the potential to enhance utilization of supervised deliveries and post-natal care services such as immunizations.

show abstract

Section: Discussionmentioning

confidence: 99%

Trends and correlates of maternal, newborn and child health services utilization in primary healthcare facilities: an explorative ecological study using DHIMSII data from one district in the Volta region of Ghana

Alhassan

Owusu‐Agyei

Ansah

et al. 2020

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…The high ANC and SBA in Ghana can be attributed to the interventions instituted by the Ministry of Health and the Government of Ghana over the past two decades. For instance, the NHIS and the free MCH policies have been instituted to enable the poor and less privileged in the country to be able to access MCH [ 16 , 17 ]. The low utilisation of PNC within 24 h could be as a result of healthcare providers not counselling women on the importance of PNC within the first 24 h. The study also observed that only a few proportions of women utilised all three components of MCH.…”

Section: Discussionmentioning

confidence: 99%

“…The National Health Insurance Scheme (NHIS), for instance, was effected in 2005 to cushion the poor [ 15 ]. The free MCH policy was subsequently added to the insurance scheme in 2008 to ensure that women who are subscribed to the insurance scheme enjoy all MCH services without any out-of-pocket payment [ 16 , 17 ]. Likewise, the Community-based Health Planning Services (CHPS) was introduced in 2008 to the fulfilment of the Universal Health Coverage (UHC) target and to reach persons in rural and remote locations with essential health care including maternal health services [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Are Ghanaian women meeting the WHO recommended maternal healthcare (MCH) utilisation? Evidence from a national survey

Ameyaw

Dickson

2021

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background To achieve the Sustainable Development Goal target 3.1, the World Health Organisation recommends that all pregnant women receive antenatal care (ANC) from skilled providers, utilise the services of a skilled birth attendant at birth and receive their first postnatal care (PNC) within the first 24 h after birth. In this paper, we examined the maternal characteristics that determine utilisation of skilled ANC, skilled birth attendance (SBA), and PNC within the first 24 h after delivery in Ghana. Methods We used data from the 2014 Ghana Demographic and Health Survey. Women aged 15-49 with birth history not exceeding five before the survey were included in the study. A total of 2839 women were included. Binary logistic regression was employed at a 95% level of significance to determine the association between maternal factors and maternal healthcare (MCH) utilisation. Bivariate and multivariate regression was subsequently used to assess the drivers. Results High proportion of women had ANC (93.2%) with skilled providers compared to the proportion that had SBA (76.9%) and PNC within the first 24 h after delivery (25.8%). Only 21.2% utilised all three components of MCH. Women who were covered by national health insurance scheme (NHIS) had a higher likelihood (AOR = 1.31, CI = 1.04 – 1.64) of utilising all three components of MCH as compared to those who were not covered by NHIS. Women with poorer wealth status (AOR = 0.72, CI = 0.53 – 0.97) and those living with partners (AOR = 0.65, CI = 0.49 – 0.86) were less likely to utilise all three MCH components compared to women with poorest wealth status and the married respectively. Conclusion The realisation that poorer women, those unsubscribed to NHIS and women living with partners have a lower likelihood of utilising the WHO recommended MCH strongly suggest that it is crucial for the Ministry of Health and the Ghana Health Service to take pragmatic steps to increase education about the importance of having ANC with a skilled provider, SBA, and benefits of having the first 24 h recommended PNC.

show abstract

“…In the pursuit of achieving the SDG target of UHC, many countries in sub-Saharan Africa (SSA) have implemented health insurance policies over the last two decades [4]. Many of the schemes currently cover public servants at both central and local government levels together with their family members while others cover the entire population [5][6][7][8][9][10][11][12][13][14]. The health insurance schemes in SSA have been introduced to largely replace the existing health financing systems which are dominated by out-of-pocket payments.…”

Section: Introductionmentioning

confidence: 99%

Mixed effects analysis of factors associated with health insurance coverage among women in sub-Saharan Africa

et al. 2021

View full text Add to dashboard Cite

Introduction In the pursuit of achieving the Sustainable Development Goal targets of universal health coverage and reducing maternal mortality, many countries in sub-Saharan Africa have implemented health insurance policies over the last two decades. Given that there is a paucity of empirical literature at the sub-regional level, we examined the prevalence and factors associated with health insurance coverage among women in in sub-Saharan Africa. Materials and methods We analysed cross-sectional data of 307,611 reproductive-aged women from the most recent demographic and health surveys of 24 sub-Saharan African countries. Bivariable and multivariable analyses were performed using chi-square test of independence and multi-level logistic regression respectively. Results are presented as adjusted Odds Ratios (aOR) for the multilevel logistic regression analysis. Statistical significance was set at p<0.05. Results The overall coverage of health insurance was 8.5%, with cross-country variations. The lowest coverage was recorded in Chad (0.9%) and the highest in Ghana (62.4%). Individual-level factors significantly associated with health insurance coverage included age, place of residence, level of formal education, frequency of reading newspaper/magazine and watching television. Wealth status and place of residence were the contextual factors significantly associated with health insurance coverage. Women with no formal education were 78% less likely to be covered by health insurance (aOR = 0.22, 95% CI = 0.21–0.24), compared with those who had higher education. Urban women, however, had higher odds of being covered by health insurance, compared with those in the rural areas [aOR = 1.20, 95%CI = 1.15–1.25]. Conclusion We found an overall relatively low prevalence of health insurance coverage among women of reproductive age in sub-Saharan Africa. As sub-Saharan African countries work toward achieving the Sustainable Development Goal targets of universal health coverage and lowering maternal mortality to less than 70 deaths per 100,000 live births, it is important that countries with low coverage of health insurance among women of reproductive age integrate measures such as free maternal healthcare into their respective development plans. Interventions aimed at expanding health insurance coverage should be directed at younger women of reproductive age, rural women, and women who do not read newspapers/magazines or watch television.

show abstract

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

Cited by 31 publications

References 30 publications

Trends and correlates of maternal, newborn and child health services utilization in primary healthcare facilities: an explorative ecological study using DHIMSII data from one district in the Volta region of Ghana

Trends and correlates of maternal, newborn and child health services utilization in primary healthcare facilities: an explorative ecological study using DHIMSII data from one district in the Volta region of Ghana

Are Ghanaian women meeting the WHO recommended maternal healthcare (MCH) utilisation? Evidence from a national survey

Mixed effects analysis of factors associated with health insurance coverage among women in sub-Saharan Africa

Contact Info

Product

Resources

About