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Maternal healthcare insurance ownership and service utilisation in Ghana: Analysis of Ghana Demographic and Health Survey

Author

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  • Sanni Yaya
  • Feng Da
  • Ruoxi Wang
  • Shangfeng Tang
  • Bishwajit Ghose

Abstract

Objectives: Previous studies have attempted to assess the role of health insurance on health care utilization in African settings. However, there is limited evidence on the effects of health insurance on use of maternal health care. In the present study our objective was to measure the prevalence of insurance ownership, types of services covered by the insurance and the association of insurance ownership with the utilization of respective maternal health services in Ghana. Methods: This study was based on nationally representative Demographic and Health Survey in Ghana (GDHS 2014) encompassing 4,293 mothers aged 15–49 years. Outcome variables were use of early antenatal care (ANC), facility delivery, and postnatal care (PNC) for mothers and children, and the explanatory variables were insurance coverage for these services. Associations were analysed using logistic regression models whilst controlling for potentially confounding variables. Results: Prevalence of health insurance ownership was 66.8% (95%CI = 64.5–68.9) with significant socioeconomic disparities. The prevalence was higher particularly among women who were urban residents, had higher educational and wealth status. In general, insurance coverage for services such as ANC, childbirth and postnatal care was higher in rural areas, but that of cash benefit was higher in urban areas. Findings of multivariate analysis indicated that women who had their ANC services covered had significantly higher odds of attending at least one and four ANC visits, as well as receiving PNC for child. Insurance coverage for childbirth services showed significant association with the PNC for child, not with choice of health facility delivery. Women who had cash benefit were twice as likely to use early ANC visit (OR = 2.046, p

Suggested Citation

  • Sanni Yaya & Feng Da & Ruoxi Wang & Shangfeng Tang & Bishwajit Ghose, 2019. "Maternal healthcare insurance ownership and service utilisation in Ghana: Analysis of Ghana Demographic and Health Survey," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-13, April.
    • Handle: RePEc:plo:pone00:0214841
    DOI: 10.1371/journal.pone.0214841
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    References listed on IDEAS

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    1. Bola Lukman Solanke, 2021. "Do the determinants of institutional delivery among childbearing women differ by health insurance enrolment? Findings from a population‐based study in Nigeria," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(3), pages 668-688, May.
    2. Herwansyah Herwansyah & Katarzyna Czabanowska & Stavroula Kalaitzi & Peter Schröder-Bäck, 2022. "Exploring the Influence of Sociodemographic Characteristics on the Utilization of Maternal Health Services: A Study on Community Health Centers Setting in Province of Jambi, Indonesia," IJERPH, MDPI, vol. 19(14), pages 1-13, July.
    3. Maxwell Tii Kumbeni & Agani Afaya & Paschal Awingura Apanga, 2023. "An assessment of out of pocket payments in public sector health facilities under the free maternal healthcare policy in Ghana," Health Economics Review, Springer, vol. 13(1), pages 1-7, December.
    4. Kofinti, Raymond Elikplim & Koomson, Isaac & Paintsil, Jones Arkoh & Ameyaw, Edward Kwabena, 2022. "Reducing children's malnutrition by increasing mothers' health insurance coverage: A focus on stunting and underweight across 32 sub-Saharan African countries," Economic Modelling, Elsevier, vol. 117(C).
    5. Abdul-Aziz Seidu, 2020. "Mixed effects analysis of factors associated with barriers to accessing healthcare among women in sub-Saharan Africa: Insights from demographic and health surveys," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-16, November.
    6. 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.

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