Evidence map›Paper›PMID 36266718›Full record

ArticleGlobal health research and policy2022

The effect of the capitation policy withdrawal on maternal health service provision in Ashanti Region, Ghana: an interrupted time series analysis.

John Kanyiri Yambah, Kofi Akohene Mensah, Naasegnibe Kuunibe, Kindness Laar, Roger Ayimbillah Atinga, Millicent Ofori Boateng, Daniel Opoku, Wilm Quentin

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Article in Global health research and policy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

8 authors.

John Kanyiri YambahUniversity Health Services, University of Education, Winneba, Ghana. yambahjohn@yahoo.com.ORCID 0000-0002-2965-2227
Kofi Akohene MensahDepartment of Health Policy, Management and Economics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Naasegnibe KuunibeDepartment of Economics, Faculty of Social Science and Arts, SD-Dombo University of Business and Integrated Development Studies, Wa, Ghana.
Kindness LaarDepartment of Health Policy, Management and Economics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Roger Ayimbillah AtingaDepartment of Public Administration and Health Services Management, University of Ghana Business School, Accra, Ghana.
Millicent Ofori BoatengDepartment of Community Health, Ensign Global College, Kpong, Ghana.
Daniel OpokuDepartment of Health Policy, Management and Economics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Wilm QuentinDepartment of Health Care Management, Technische Universitat Berlin, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPayment methods are known to influence maternal care delivery in health systems. Ghana suspended a piloted capitation provider payment system after nearly five years of implementation. This study aimed to examine the effects of Ghana's capitation policy on maternal health care provision as part of lesson learning and bridging this critical literature gap.

methodsWe used secondary data in the District Health Information Management System-2 and an interrupted time series design to assess changes in level and trend in the provision of ANC4+ (visits of pregnant women making at least the fourth antenatal care attendance per month), HB36 (number of hemoglobin tests conducted for pregnant women who are at the 36th week of gestation) and vaginal delivery in capitated facilities-CHPS (Community-based Health Planning and Services) facilities and hospitals.

resultsThe results show that the capitation policy withdrawal was associated with a statistically significant trend increase in the provision of ANC4+ in hospitals (coefficient 70.99 p < 0. 001) but no effect in CHPS facilities. Also, the policy withdrawal resulted in contrasting effects in hospitals and CHPS in the trend of provision of Hb36; a statistically significant decline was observed in CHPS (coefficient - 7.01, p < 0.05) while that of hospitals showed a statistically significant trend increase (coefficient 32.87, p < 0.001). Finally, the policy withdrawal did not affect trends of vaginal delivery rates in both CHPS and hospitals.

conclusionsThe capitation policy in Ghana appeared to have had a differential effect on the provision of maternal services in both CHPS and hospitals; repressing maternal care provision in hospitals and promoting adherence to anemia testing at term for pregnant women in CHPS facilities. Policy makers and stakeholders should consider the possible detrimental effects on maternal care provision and quality in the design and implementation of per capita primary care systems as they can potentially impact the achievement of SDG 3.

Indexed as

Maternal Health ServicesFemaleGhanaHemoglobinsHumansInterrupted Time Series AnalysisPolicyPregnancyHemoglobinsAnemia testsCapitation policyCHPSDeliveryHospitalsMaternal care

Identifiers

PMID36266718
PMCPMC9585820

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.