ArticleBMC health services research2024
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.
Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Factors influencing antenatal care utilisation in Madang Province, Papua New Guinea: a qualitative study.BMC pregnancy and childbirth · 2026Article
- Assessing antenatal care utilization, socioeconomic inequalities and low birth weight outcomes: a population-based analysis using the 2022 Ghana demographic and health survey data.BMC pediatrics · 2026Article
- Impact of Ghana's fee exemption policy on maternal health service utilisation: an inverse probability of treatment weighting analysis of pooled national data.Journal of global health · 2025Article
- Determinants of adequate antenatal care for underage mothers in Indonesia: Urban-rural inequities.Journal of family & community medicineArticle
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6 authors.
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Abstract
backgroundIn 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.
methodsThe 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.
resultsAntenatal 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.
conclusionsAntenatal 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.
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