IDEAS home Printed from https://ideas.repec.org/a/kap/ijhcfe/v21y2021i1d10.1007_s10754-020-09288-w.html
   My bibliography  Save this article

National health insurance and the choice of delivery facility among expectant mothers in Ghana

Author

Listed:
  • Richard Agbanyo

    (University of Professional Studies, Accra)

  • James Atta Peprah

    (University of Cape Coast)

Abstract

The effectiveness of health insurance in removing barriers to the utilisation of maternal healthcare in order to curb maternal mortality especially in developing countries is gaining ground. However, in assessing the effects of health insurance on choice of delivery facilities, previous studies either put all delivery services together and used binary techniques or failed to address endogeneity problem. Moreover, the age of data used for such analysis in Ghana may not tell a convincing story. This study used data from the 2014 to 2008 Ghana Demographic and Health Surveys with a sample of 6319 women and employed multinomial endogenous treatment effects models with Conditional Mixed Process estimator to examine the effects of national health insurance scheme (NHIS) on the choice delivery facility in Ghana. We found that NHIS has varied effects on the use of delivery services across service providers in the health system. Relative to home delivery services, being insured increases the probability of using public hospitals, public clinics and private health facilities for delivery by 20.3 percent, 9.1 percent and 2.3 percent respectively. Moreover, relative to an insured woman who gave birth before 2008, her counterpart who gave birth after 2008 is 6.3 percent, 4.9 percent and 0.77 percent more likely to use public hospitals, public clinics and private health facilities respectively for delivery.

Suggested Citation

  • Richard Agbanyo & James Atta Peprah, 2021. "National health insurance and the choice of delivery facility among expectant mothers in Ghana," International Journal of Health Economics and Management, Springer, vol. 21(1), pages 27-49, March.
    • Handle: RePEc:kap:ijhcfe:v:21:y:2021:i:1:d:10.1007_s10754-020-09288-w
    DOI: 10.1007/s10754-020-09288-w
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10754-020-09288-w
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1007/s10754-020-09288-w?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    2. Hamdiyah Alhassan & Benjamin Musah Abu & Paul Kwame Nkegbe, 2020. "Access to Credit, Farm Productivity and Market Participation in Ghana: A Conditional Mixed Process Approach," Margin: The Journal of Applied Economic Research, National Council of Applied Economic Research, vol. 14(2), pages 226-246, May.
    3. Joseph Mensah & Joseph R. Oppong & Christoph M. Schmidt, 2010. "Ghana's national health insurance scheme in the context of the health MDGs: an empirical evaluation using propensity score matching," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 95-106, September.
    4. Kannika Damrongplasit & Tshering Wangdi, 2017. "Healthcare utilization, bypass, and multiple visits: the case of Bhutan," International Journal of Health Economics and Management, Springer, vol. 17(1), pages 51-81, March.
    5. Chamberlain, Gary & Griliches, Zvi, 1975. "Unobservables with a Variance-Components Structure: Ability, Schooling, and the Economic Success of Brothers," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 16(2), pages 422-449, June.
    6. Munkin, Murat K. & Trivedi, Pravin K., 2003. "Bayesian analysis of a self-selection model with multiple outcomes using simulation-based estimation: an application to the demand for healthcare," Journal of Econometrics, Elsevier, vol. 114(2), pages 197-220, June.
    7. Stephen Abrokwah & Christine Moser & Edward Norton, 2014. "The effect of social health insurance on prenatal care: the case of Ghana," International Journal of Health Economics and Management, Springer, vol. 14(4), pages 385-406, December.
    8. Matthew Jowett & Anil Deolalikar & Peter Martinsson, 2004. "Health insurance and treatment seeking behaviour: evidence from a low‐income country," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 845-857, September.
    9. David Roodman, 2011. "Fitting fully observed recursive mixed-process models with cmp," Stata Journal, StataCorp LP, vol. 11(2), pages 159-206, June.
    10. G. Salkeld & M. Ryan & L. Short, 2000. "The veil of experience: do consumers prefer what they know best?," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 267-270, April.
    11. Courtemanche, Charles & Tchernis, Rusty & Ukert, Benjamin, 2018. "The effect of smoking on obesity: Evidence from a randomized trial," Journal of Health Economics, Elsevier, vol. 57(C), pages 31-44.
    12. Wagner, Anita K. & Graves, Amy Johnson & Reiss, Sheila K. & LeCates, Robert & Zhang, Fang & Ross-Degnan, Dennis, 2011. "Access to care and medicines, burden of health care expenditures, and risk protection: Results from the World Health Survey," Health Policy, Elsevier, vol. 100(2), pages 151-158.
    13. Maitra, Pushkar, 2004. "Parental bargaining, health inputs and child mortality in India," Journal of Health Economics, Elsevier, vol. 23(2), pages 259-291, March.
    14. Thang Dang, 2018. "Do the more educated utilize more health care services? Evidence from Vietnam using a regression discontinuity design," International Journal of Health Economics and Management, Springer, vol. 18(3), pages 277-299, September.
    15. Emily Gustafsson-Wright & Gosia Popławska & Zlata Tanović & Jacques Gaag, 2018. "The impact of subsidized private health insurance and health facility upgrades on healthcare utilization and spending in rural Nigeria," International Journal of Health Economics and Management, Springer, vol. 18(3), pages 221-276, September.
    16. Wagner, Anita K. & Graves, Amy Johnson & Reiss, Sheila K. & LeCates, Robert & Zhang, Fang & Ross-Degnan, Dennis, 2011. "Access to care and medicines, burden of health care expenditures, and risk protection: Results from the World Health Survey," Health Policy, Elsevier, vol. 100(2-3), pages 151-158, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 22nd March 2021
      by Chris Sampson in The Academic Health Economists' Blog on 2021-03-22 12:00:01

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Dossè Mawussi DJAHINI-AFAWOUBO, 2023. "Niveau d’éducation et probabilité d’être employé dans le secteur informel au Togo," Region et Developpement, Region et Developpement, LEAD, Universite du Sud - Toulon Var, vol. 57, pages 29-48.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Richard Agbanyo, 2020. "Ghana's national health insurance, free maternal healthcare and facility‐based delivery services," African Development Review, African Development Bank, vol. 32(1), pages 27-41, March.
    2. Fan, Victoria Y. & Savedoff, William D., 2014. "The health financing transition: A conceptual framework and empirical evidence," Social Science & Medicine, Elsevier, vol. 105(C), pages 112-121.
    3. El-Sayed, Abdulrahman M. & Palma, Anton & Freedman, Lynn P. & Kruk, Margaret E., 2015. "Does health insurance mitigate inequities in non-communicable disease treatment? Evidence from 48 low- and middle-income countries," Health Policy, Elsevier, vol. 119(9), pages 1164-1175.
    4. Simphiwe Innocentia Hlatshwayo & Rob Slotow & Mjabuliseni Simon Cloapas Ngidi, 2023. "The Role of Smallholder Farming on Rural Household Dietary Diversity," Agriculture, MDPI, vol. 13(3), pages 1-16, February.
    5. Cesur, Resul & Güneş, Pınar Mine & Tekin, Erdal & Ulker, Aydogan, 2017. "The value of socialized medicine: The impact of universal primary healthcare provision on mortality rates in Turkey," Journal of Public Economics, Elsevier, vol. 150(C), pages 75-93.
    6. Lan Thi Thu Phan & Yusuke Jinnai, 2018. "Does health insurance matter in the hospital? New evidence from patient-level medical records in Vietnam," Working Papers EMS_2018_01, Research Institute, International University of Japan.
    7. Santosh Kumar & Fidel Gonzalez, 2018. "Effects of health insurance on birth weight in Mexico," Health Economics, John Wiley & Sons, Ltd., vol. 27(8), pages 1149-1159, August.
    8. Barış Alpaslan & Julide Yildirim, 2020. "The Missing Link: Are Individuals with More Social Capital in Better Health? Evidence from India," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 150(3), pages 811-834, August.
    9. Mabe, Franklin N. & Nashiru, Sulemena & Mummuni, Eliasu & Boateng, Vivian F., 2019. "The nexus between land acquisition and household livelihoods in the Northern region of Ghana," Land Use Policy, Elsevier, vol. 85(C), pages 357-367.
    10. Barnay, Thomas & Juin, Sandrine, 2016. "Does home care for dependent elderly people improve their mental health?," Journal of Health Economics, Elsevier, vol. 45(C), pages 149-160.
    11. Manoj K. Pandey, 2013. "Elderly's Health Shocks and Household's Ex-ante Poverty in India," ASARC Working Papers 2013-01, The Australian National University, Australia South Asia Research Centre.
    12. Neuman, Einat & Neuman, Shoshana, 2006. "Explorations of the Effect of Experience on Preferences: Two Health-Care Case Studies," IZA Discussion Papers 2028, Institute of Labor Economics (IZA).
    13. Maryam Bigdeli & Bart Jacobs & Chean Rithy Men & Kristine Nilsen & Wim Van Damme & Bruno Dujardin, 2016. "Access to Treatment for Diabetes and Hypertension in Rural Cambodia: Performance of Existing Social Health Protection Schemes," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-18, January.
    14. Bereket Yakob & Busisiwe Purity Ncama, 2016. "Correlates of perceived access and implications for health system strengthening – lessons from HIV/AIDS treatment and care services in Ethiopia," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-19, August.
    15. Pushkar Maitra & Sarmistha Pal, 2004. "Early Childbirth, Health Inputs and Child Mortality: Recent Evidence from Bangladesh," HEW 0411004, University Library of Munich, Germany.
    16. Koch, Kira Johanna & Cid Pedraza, Camilo & Schmid, Andreas, 2017. "Out-of-pocket expenditure and financial protection in the Chilean health care system—A systematic review," Health Policy, Elsevier, vol. 121(5), pages 481-494.
    17. Xiaojing Li & Xianli Xia & Jiazhen Ren, 2022. "Can the Participation in Quality Certification of Agricultural Products Drive the Green Production Transition?," IJERPH, MDPI, vol. 19(17), pages 1-16, September.
    18. Chiara Mussida & Raffaella Patimo, 2021. "Women’s Family Care Responsibilities, Employment and Health: A Tale of Two Countries," Journal of Family and Economic Issues, Springer, vol. 42(3), pages 489-507, September.
    19. Gerald Makepeace & Sarmistha Pal, 2008. "Understanding the effects of siblings on child mortality: evidence from India," Journal of Population Economics, Springer;European Society for Population Economics, vol. 21(4), pages 877-902, October.
    20. Faden, Laura & Vialle-Valentin, Catherine & Ross-Degnan, Dennis & Wagner, Anita, 2011. "Active pharmaceutical management strategies of health insurance systems to improve cost-effective use of medicines in low- and middle-income countries: A systematic review of current evidence," Health Policy, Elsevier, vol. 100(2), pages 134-143.

    More about this item

    Keywords

    National health insurance; Place of delivery; Multinomial endogenous treatment effect model; Conditional mixed process; Ghana;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • B54 - Schools of Economic Thought and Methodology - - Current Heterodox Approaches - - - Feminist Economics

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:kap:ijhcfe:v:21:y:2021:i:1:d:10.1007_s10754-020-09288-w. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.