Feb 14, 1991 the study investigates the effect of wealth on maternal health care utilization in ghana via its effect on antenatal care use. In this issue we publish articles resulting from an evaluation of ghana s free delivery care policy 3 carried out under the auspices of the initiative for maternal mortality programme assessment immpact 4 and other reports on obstetric care. Two decades of maternity care fee exemption policies in ghana. This study aimed to evaluate if women registered with the insurance had a better chance of accessing maternal healthcare services in two districts in ghana. Although supervised delivery in ghana has increased from 47% in 2003 to 55% in 2010. These figures have persisted for some time despite various policies.
Under the policy, women are entitled to free services throughout pregnancy and at childbirth. Pdf the government of ghana from the 1990s has tried a lot of policies to finance healthcare in ghana. Originalityvalue to the best of my knowledge this is the first empirical study to examine the effect of government expenditure and free maternal healthcare policy on household consumption in ghana. Investigating the impact of the national health insurance scheme on maternal health indicators negligible. Feb 01, 2018 introduction the free maternal health policy was implemented in ghana in 2008 under the national health insurance scheme nhis. Open access research effectiveness of a free maternal.
Dec 21, 2014 background to reduce financial barriers to access, and improve access to and use of skilled maternal and newborn healthcare services, the government of ghana, in 2003, implemented a new maternal healthcare policy that provided free maternity care services in all public and mission healthcare facilities. Oct, 2020 ghana, under the national health insurance scheme nhis in july 2008 introduced a free maternal health policy which made it possible for all pregnant women to be entitled to free health services. The chapter discussed the state of maternal health and maternal mortality in the global context, maternal mortality in ghana, policies targeted at reducing maternal. Has the free maternal health policy eliminated out of pocket payments for maternal health services. Why muslim women in northern ghana do not use skilled. The benefits during the free delivery care and nhis policy periods accrued more. Due to the introduction of the national health insurance scheme in 2003, along with related policies in maternal and child health care, ghana has seen a marked improvement in the provision of healthcare for all of its. For example, the ghana e health policy document provides guidance for the. Data analysis involved chronologically reconstructing how maternal health policy items evolved over time. These reforms aimed at improving the utilization of healthcare, especially for expectant mothers. Pdf national health insurance and free maternal healthcare in. Although evidence shows that there has been some succe. The policy allows all pregnant women to have free registration with the nhis after which they would be entitled to free services throughout pregnancy, childbirth and 3 months postpartum.
Effectiveness of a free maternal healthcare programme. Improve efficiency in governance and management of the health system 4. The 2017 ghana maternal health survey gmhs is designed to provide data for monitoring the maternal health situation in ghana. Improving maternal healthcare remains a major public health concern globally but particularly in subsaharan africa.
Introduction a free maternal health policy was implemented in ghana in july 2008 under the national health insurance scheme nhis. The 2017 ghana maternal health survey 2017 gmhs was implemented by the ghana statistical service gss and the ghana health service ghs from 15 june through 12 october 2017. In ghana, maternal mortality ratio is estimated to range from 214 to 700 per 100,000 live births. Dickerson, and sarah alkenbrack of the health policy project. Northern ghana, maternal health, maternal healthcare access, religion, islam, muslim women background increasing the proportion of women who receive skilled maternal healthcare services, especially skilled attendance at delivery, is one of the most important policy actions needed to reduce maternal mortality in lowincome countries. The findings from this study also have important implications for both fiscal policy and healthcare policy in ghana and other developing countries. We discuss key issues like the free maternal healthcare package, transportation and referral concerns, human resources challenges.
The result suggests that government expenditure and free maternal healthcare policy crowedout private consumption in ghana. Different policies were introduced by different governments until 2003 when president john. Ghana has made great strides in improving access to maternal health services in the past 15 years, largely because of the presidents launch of the free maternal health initiative, financed through the national health insurance scheme nhis. Trends and projections of universal health coverage. Male involvement in maternal healthcare through community. The results revealed that government expenditure and free maternal healthcare policy had a negative and statistically significant effect of on household consumption expenditure in ghana in both long run and short run. The government of ghana s therefore declared free maternal healthcare to deal with the problem of severe maternal mortality which had reached high levels to the point of being declared as a national emergency in 2008 kyeinimako, 2016. In 2008, the government of ghana implemented a national user fee maternal care exemption policy through the national health insurance scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. A free maternal health policy was implemented under ghana s national health insurance scheme to promote the use of maternal health services. Outofpocket payments in the context of a free maternal. The funding for the 2017 gmhs was provided by the government of ghana, the united states agency for international development usaid. To evaluate the impact of the national health insurance schemes free maternal care program fmcp on maternal health care utilization and mortality rates.
Social determinants and the role of maternal health care. Ghanas free maternal healthcare policy not working. The main objectives of this study are to analyze the impact of government expenditure and free maternal healthcare policy on household consumption expenditure in ghana using the ardl estimation. Mohunaidswho water and sanitation ghana child protection 93 63 68 57 90 24 0 20406080100 measles exclusive breastfeeding postnatal care skilled attendant at birth antenatal visit 1 or more contraceptive prevalence rate % 18 33 3 68 58. Improving access and utilization of maternal healthcare. The free maternal healthcare policy was therefore policy grafted out of the mdg acceleration. Based on the concerns raised in previous studies that male spouses were indifferent towards maternal healthcare, this study sought the views of men on their involvement in. May 22, 2019 in addition, the maternal health program branded as the free maternal health policy as a part of the nhis, granted to women upon confirmation of pregnancy and enrollment into the nhis, completely eliminates oop payments for six antenatal care visits, delivery care, two postnatal care visits, and infant care up to three months of age. This could be done through 1 addressing financial loopholes in the free maternal health care policy in ghana to eliminate direct and indirect. The 2017 gmhs is the second maternal health survey conducted in ghana since 2007. Sep 06, 2017 background the need to promote maternal health in ghana has committed the government to extend maternal healthcare services to the door steps of rural families through the communitybased health planning and services. The free maternal healthcare policy in ghana e fmhcp was introduced in ghana through a politi cal declaration in july 2008 by the government of ghana, with no prior policy framework. The national health insurance scheme nhis free maternal healthcare programme was introduced in july 2008 to help ghana meet millennium development. Oct 30, 2020 ghana introduced what has come to be known as the free maternal health care policy fmhcp in 2008 via the free registration of pregnant women to the national health insurance scheme to access healthcare free of charge.
In 2008, the government of ghana implemented a national user fee maternal care exemption policy through the national health insurance scheme to improve. Improve quality of health services delivery including mental health services 5. Pdf national health insurance and free maternal healthcare. Has the free maternal health policy eliminated out of.
Jun 07, 2019 accra, ghana on june 6, the ministry of health together with the united states government through the united states agency for international development usaid held a maternal and child survival symposium. The national target was to reduce mmr from 214 1990 to 54 in 2015 7. Pdf implementation of feefree maternal healthcare policy in. The health sector in ghana the health services include government, private, traditional and ngo providers, civil society, and community groups involves collaboration and partnership with other agencies with impact on health outcomes. Free maternal health care policy and access to supervised. In 2008, the government of ghana implemented a national user fee maternal care exemption policy through the national health insurance scheme to improve financial access to maternal health services. Moreover, a free delivery health care policy was introduced in 2003, which was. The free maternal health policy was implemented in ghana in 2008 under the national health insurance scheme nhis. Implementation of feefree maternal healthcare policy in. A closer look at the healthcare system in ghana healthcare financing health expenditure.
May 29, 2018 introduction a free maternal health policy was implemented in ghana in july 2008 under the national health insurance scheme nhis. Ghana introduced what has come to be known as the free maternal health care policy fmhcp in 2008 via the free registration. Presently, maternal mortality rate in ghana ranges from 240 to 800 per 100,000 live births. The effect of government expenditure and free maternal health. Enhance national capacity for the attainment of the health related mdgs and sustain the gains. The effect of government expenditure and free maternal. In ghana, for instance, the maternal mortality ratio in 2005 was estimated at 560 maternal. We recommend that policy actions aimed at reducing inequality in maternal health in ghana should target education and incomerelated inequalities simultaneously. Then in 2008, the government introduced the free maternal health insurance policy through the national health insurance scheme 6. Ensure sustainable financing for healthcare delivery and financial protection for the poor 3.
Benefits of improving access to family planning in ghana. Objectives in her quest to reduce maternal mortality, ghana introduced a free maternal healthcare programme under the national health insurance scheme. Antenatal care serves as the initial point of contact of expectant mothers to maternal health care providers before delivery. Impact of free maternal health care policy on maternal. A free maternal health policy was implemented in ghana in july 2008 under the national health insurance scheme nhis. Apr 23, 2016 the free maternal health care policy, which begun in ghana in 2008, is being implemented through the national health insurance scheme aimed at facilitating access to free and quality maternal health care services such as antenatal, delivery and postnatal care at health facilities. However, progress in increasing access to family planning fp has been more limited. Ghanas national health insurance, free maternal healthcare. The objective of the survey was to provide reliable estimates of fertility levels and preferences, family planning methods, pregnancy. In ghana, there has been a steady increase in the number of facilitybased deliveries from about 300,000 in 2007 to about 500,000 in 2011 since the inception of free maternal healthcare in 2008. Impact of free maternal health care policy on maternal health care. The policy sought to eliminate out of pocket oop payments and enhance the utilisation of maternal health services.
Impact of nhis free maternal healthcare policy on utilization of. Implementation of feefree maternal healthcare policy in ghana. The main policy recommendation from the work is that there should be increased education on the full benefit package of the free maternal healthcare policy to ensure optimum use of antenatal, delivery and postnatal care pnc services among women in all accredited facilities. The maternal care fee exemption policies specifically. To improve access to quality, efficient and seamless health. The implementation of the free maternal health policy in.
These findings are not peculiar to ghana because in kenya the introduction of free maternal healthcare service policy gave rise to an increase in facility delivery. Jan 07, 2019 however, womens unawareness of free maternal health service, especially among vulnerable groups negatively influences the utilization of healthcare. In covid19 pandemic era when most households members have lost their jobs and incomes, the government assistance and programs in ensuring consumption smoothing is imperative. Access to maternal healthcare services under the national health. The policy covered delivery services in public, private and faithbased health facilities. Impact of free maternal health care policy on maternal health. Pdf implementation of feefree maternal healthcare policy. Effectiveness of a free maternal healthcare programme under the. This policy brief is intended to complement the efforts of maternal health. Policy guidelines on reproductive healthcare in ghana. Has the free maternal health policy eliminated out of pocket. Towards an explanatory framework for national level maternal. Ghana maternal health survey 2017 key indicators report. The policy targeted every pregnant woman in ghana with a full benefits package covering comprehensive maternal healthcare.
In 2008, the government of ghana implemented a national user fee maternal care exemption policy through the national health insurance. National health policy revised edition 2020 national medicines policy 3rd edition, 2017 policy on antimicrobial used and resistance ghana national action plan on antimicrobial resistance 20172021 ghana national healthcare quality strategy 20172021 health sector staffing norm antimalaria drug policy national chps policy ghana national drug policy 2nd edition ghana e health. Mar 18, 2020 ghana implemented the national health insurance scheme nhis in 2005 and introduced free maternal healthcare fmh into the scheme in 2008. Given the significant role of government expenditure and free maternal health care policy in household consumption smoothing, to the best of my knowledge, no empirical study has analyzed the impact of government spending and free maternal health care policy on household consumption in ghana. It is unclear whether the policy had altered oop payments for services. Access and utilization of maternal healthcare in a rural. The study explored views on costs and actual oop payments during pregnancy. Free maternal health care policy and access to supervised care at.
Ghana 2017 maternal health survey key findings sr251. Motivations for nonformal maternal health care in lowincome. The implementation of the free maternal health policy in rural. Mar 27, 2019 the operations of the free maternal care policy and out of pocket payments during childbirth in rural northern ghana. The study is pivoted on the introduction of the free maternal health care policy in april 2005 in ghana with the aim of reducing the financial. Effectiveness of a free maternal healthcare programme under. Determinants of antenatal healthcare utilisation by pregnant. Jul 11, 2019 the 2017 ghana maternal health survey 2017 gmhs was designed to produce representative estimates for maternal mortality indicators for the country as a whole, and for each of the three geographical zones, namely coastal western, central, greater accra and volta, middle eastern, ashanti and brong ahafo and northern northern, upper east and upper west.
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