Abstract

Health insurance coverage provides the spring board for pregnant women to access and utilise maternal healthcare services. Yet, studies on health insurance coverage, access and utilisation of maternal healthcare are a handful. Consequently, this study examines women's access and utilisation of maternal healthcare services under the free maternal health policy in two districts in northern Ghana. The study adopted the mixed research approach with the aid of the cross-sectional design involving 212 respondents. An interview schedule was utilised in the collection of data. Percentages, Chi-square test for independence and Mann-Whitney U test as well as thematic analysis were used to analyse the data. The study revealed that 93.9% of the respondents had enrolled unto the national health insurance scheme and 98.6% of them went for antennal care. Majority (66.5%) of them had facility-based delivery. However, 79.7% of them incur cost in seeking delivery care. In brief, health insurance coverage appears to contribute to improved access and utilisation of maternal healthcare services in the two districts. Nonetheless, the government should provide the basic items that are needed for delivery to lessen the cost burden associated with facility-based delivery.

Highlights

  • Access to healthcare including maternal healthcare services drives public health policies across the globe [1–3]

  • The results of the analysis show that 93.9% of the respondents had enrolled unto the national health insurance scheme whereas the rest had not registered to benefit from the exemption of pregnant women from paying the premium

  • The results showed that 55.1% of the respondents in the Wa East district noted that they pay for services when they sought for antenatal care whereas the rest indicated that they did not pay for anything when they sought antenatal care services

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Summary

Introduction

Access to healthcare including maternal healthcare services drives public health policies across the globe [1–3]. The expending of national resources in the form of free enrolment of pregnant women onto the national health insurance scheme [NHIS] seeks to guarantee access and utilisation of maternal healthcare services. Children under 18 years old, elderly above 70 years old, Social Security and National Insurance Trust (SSNIT) pensioners, pregnant women, and extreme poor do not pay the premium [22] This signals that exemption of pregnant women from paying the premium seeks to do away with financial barriers to maternal healthcare services and to reduce or eradicate pregnancy-related deaths. GHS [23] posits that the Upper West Region is characterised by scattered health facilities which contribute to poor access to healthcare This begs the question of whether enrolment and exemption of pregnant women from the payment of the NHIS’s premium guarantees access and utilisation of maternal healthcare service in the region. The fourth section presents the methodology adopted for the study and the fifth section presents the empirical evidence of the study, while conclusions and policy implications constitute the final section

Conceptual discussions
Empirical review
Study methods
Background characteristics of respondents
Access to maternal healthcare
Utilisation of maternal health services
Findings
Conclusions and policy implications
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