Maternal health care utilization following the implementation of the free maternal health care policy in Ghana : analysis of Ghana demographic and health surveys 2008-2014
© 2024. The Author(s)..
BACKGROUND: In July 2008, Ghana introduced a 'free' maternal health care policy (FMHCP) through the national health insurance scheme (NHIS) to provide comprehensive antenatal, delivery and post-natal care services to pregnant women. In this study, we evaluated the 'free' policy impact on antenatal care uptake and facility-level delivery utilization since the policy inception.
METHODS: The study used two rounds of repeated cross-sectional data from the Ghana Demographic and Health Survey (GDHS, 2008-2014) and constructed exposure variable of the FMHCP using mothers' national health insurance status as a proxy variable and another group of mothers who did not subscribe to the policy. We then generated the propensity scores of the two groups, ex-post, and matched them to determine the impact of the 'free' maternal health care policy as an intervention on antenatal care uptake and facility-level delivery utilization, using probit and logit models.
RESULTS: Antenatal care uptake and facility-level delivery utilization increased by 8 and 13 percentage points difference, observed coefficients; 0.08; CI: 95% [0.06-0.10]; p < 0.001 and 0.13; CI: 95% [0.11-0.15], p < 0.001, respectively. Pregnant women were 1.97 times more likely to make four plus [a WHO recommended number of visits at the time] antenatal care visits and 1.87 times more likely to give birth in a health care facility of any level in Ghana between 2008 and 2104; aOR = 1.97; CI: 95% [1.61-2.4]; p < 0.001 and aOR = 1.87; CI: 95% [1.57-2.23]; p < 0.001, respectively.
CONCLUSIONS: Antenatal care uptake and facility-level delivery utilization improved significantly in Ghana indicating a positive impact of the FMHCP on maternal health care utilization in Ghana since its implementation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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| Enthalten in: |
BMC health services research - 24(2024), 1 vom: 15. Feb., Seite 207 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Azaare, John [VerfasserIn] |
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| Links: |
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| Themen: |
Antenatal care uptake |
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| Anmerkungen: |
Date Completed 19.02.2024 Date Revised 19.02.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1186/s12913-024-10661-5 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368507904 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s). | ||
| 520 | |a BACKGROUND: In July 2008, Ghana introduced a 'free' maternal health care policy (FMHCP) through the national health insurance scheme (NHIS) to provide comprehensive antenatal, delivery and post-natal care services to pregnant women. In this study, we evaluated the 'free' policy impact on antenatal care uptake and facility-level delivery utilization since the policy inception | ||
| 520 | |a METHODS: The study used two rounds of repeated cross-sectional data from the Ghana Demographic and Health Survey (GDHS, 2008-2014) and constructed exposure variable of the FMHCP using mothers' national health insurance status as a proxy variable and another group of mothers who did not subscribe to the policy. We then generated the propensity scores of the two groups, ex-post, and matched them to determine the impact of the 'free' maternal health care policy as an intervention on antenatal care uptake and facility-level delivery utilization, using probit and logit models | ||
| 520 | |a RESULTS: Antenatal care uptake and facility-level delivery utilization increased by 8 and 13 percentage points difference, observed coefficients; 0.08; CI: 95% [0.06-0.10]; p < 0.001 and 0.13; CI: 95% [0.11-0.15], p < 0.001, respectively. Pregnant women were 1.97 times more likely to make four plus [a WHO recommended number of visits at the time] antenatal care visits and 1.87 times more likely to give birth in a health care facility of any level in Ghana between 2008 and 2104; aOR = 1.97; CI: 95% [1.61-2.4]; p < 0.001 and aOR = 1.87; CI: 95% [1.57-2.23]; p < 0.001, respectively | ||
| 520 | |a CONCLUSIONS: Antenatal care uptake and facility-level delivery utilization improved significantly in Ghana indicating a positive impact of the FMHCP on maternal health care utilization in Ghana since its implementation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antenatal care uptake | |
| 650 | 4 | |a Facility delivery | |
| 650 | 4 | |a Free maternal health care policy | |
| 650 | 4 | |a Impact evaluation | |
| 650 | 4 | |a Maternal health care utilization | |
| 700 | 1 | |a Aninanya, Gifty Apiung |e verfasserin |4 aut | |
| 700 | 1 | |a Abdulai, Kasim |e verfasserin |4 aut | |
| 700 | 1 | |a Adane, Francis |e verfasserin |4 aut | |
| 700 | 1 | |a Bio, Robert Bagngmen |e verfasserin |4 aut | |
| 700 | 1 | |a Hushie, Martin |e verfasserin |4 aut | |
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