Effect of National Health Insurance Holding on the Choice of Health Facility for Childbirth in Ghana
Science Journal of Public Health
Volume 4, Issue 1, January 2016, Pages: 26-36
Received: Jan. 2, 2016;
Accepted: Jan. 13, 2016;
Published: Jan. 29, 2016
Views 3895 Downloads 155
Salifu Mubarik, Institute of Distance Education, University of Cape Coast, Tamale Center, Ghana
Seidu Al-hassan, Institute for Continuing Education and Interdisciplinary Research, University for Development Studies, Tamale, Ghana
Nkechi S. Owoo, Department of Economics, University of Ghana, Legon, Ghana
Boakye-Yiadom Louis, Department of Economics, University of Ghana, Legon, Ghana
Maternal and child mortalities are among major health problems facing developing countries such as Ghana. Most of these deaths can be avoided by utilization of maternity health care services. The study examines the effect of health insurance holding and other socioeconomic and demographic factors on the choice of health facility for childbirth in Ghana. The study used data from the 2008 Ghana Demographic and Health survey. Data were analyzed for descriptive statistics as well as a Multinomial Logistic Regression for identification of factors that influence delivery in health facility. The study results have shown that, holding of health insurance and wealth significantly influences expectant mother’s decision to use government health facilities for childbirth. Also, the study revealed considerable variations in region and between rural and urban utilization of this services in Ghana. It is recommended that in order to improve the utilization of health facility for childbirth services and hence maternal health care utilization, there is the need to improve public awareness and efforts should also be taking by policy makers to integrate the private sector properly into the National Health Insurance scheme. Policy should also target mothers who have had the experience of child birth on the need to use health care facility services for each pregnancy. The government and other service providers (NGOs, religious institutions and private providers) may endeavor to improve on the distribution of health facilities, human resources, good roads and necessary infrastructure among other things in order to facilitate easy access to health care providers especially for rural dwellers.
Nkechi S. Owoo,
Effect of National Health Insurance Holding on the Choice of Health Facility for Childbirth in Ghana, Science Journal of Public Health.
Vol. 4, No. 1,
2016, pp. 26-36.
Abor P, Abekah-Nkrumah G, Sakyi K, Adjasi C, Abor J (2011): The socio-economic determinants of maternal health care utilization in Ghana. Int J Soc Econ 2011, 38: 628–648
Addai, I. (2000), “Determinants of use of maternal-child health services in rural Ghana”, Journal of Biosocial Science, Vol. 32 No. 1, pp. 1-15.
Arthur (2012): Wealth and Antenatal Care Use: Implications for maternal Health care Utilization in Ghana. Health Economics Review 2012, 2: 14.
Atim, C, Grey, S, Apoya, P. (2001). A survey of Health Financing Schemes in Ghana. Partners for Health Reform plus (PHRplus). Betheseda, MD: Abt Associates Inc.
Babalola S, Fatusi A (2009). Determinants of use of maternal health services in Nigeria – looking beyond individual and household factors. BMC Pregnancy & Childbirth. Retrieved October 2013, from www.biomedcentral.com/bmcpregnancychildbirth.
Bhatia, M. R. and Gorter, A. C. 2007, "Improving Access to Reproductive and Child Health Services in Developing Countries: Are competitive voucher schemes an option?” Journal of International Development, vol. 19, pp. 975-981.
Caldwell, J. C. (1979). Education is a factor in mortality decline an examination of Nigerian data. Population Studies, 33(3), 395-413. Retrieved November 2013, from www.jstor.org/stable/10.2307/2173888.
Caldwell, J. C. (1990). Routes to low mortality in poor countries, Population and Development Review, 12(2), 171-220. Retrieved December 2013, from www.popcouncil.org/pdr/.
Chakraborty, N., Islam, M. A., Chowdhury, R. I., Bari, W. and Akhter, H. H. (2003), “Determinants of the use of maternal health services in rural Bangladesh”, Health Promotion International, Vol. 18 No. 4, pp. 327-37.
Elo, I. T. (1992), “Utilization of maternal health care services in Peru: the role of women’s education”, Health Transition Review, Vol. 2 No. 1, pp. 49-69.
Fosu, G. B. (1994), “Childhood morbidity and health services utilization: cross-national comparisons of user-related factors from DHS data”, Social Science & Medicine, Vol. 38, pp. 1209-20.
Gage, A. J. (2007), “Barriers to the utilization of maternal health care in rural Mali”, Social Science & Medicine, Vol. 65 No. 8, pp. 1666-82.
Ghana Health Service Annual Report (2010), Reproductive and Child Health Unit, Public HealthUnit, Goulburn.
Ghana Health Service Annual Report (2011), Reproductive and Child Health Unit, Public Health Unit, Goulburn.
Ghana Health Service Annual Report (2012), Reproductive and Child Health Unit, Public Health Unit, Goulburn.
Ghana Statistical Service (GSS), and Ghana Health Service (GHS). (2009). Ghana demographic and health survey reports 2008. Accra, Ghana: Ghana Statistical Service.
Ghana Statistical Service (GSS). (2011). 2010 population and housing census provisional results: Summary of findings. Accra, Ghana: Ghana Statistical Service. Retrieved November 2013, from www.modernghana.com.
Ghana Statistical Service (GSS): Noguchi Memorial Institute for Medical Research (NMIMR), and ORC Macro: Ghana Demographic and Health Survey2008. Calverton, Maryland: GSS, NMIMR, and MI; 2009.
Grossman M: On the concept of Human Capital and the Demand for Health. J Polit Econ 1972, 80: 223–235.
Grossman, M. (1972). The demand for health: A theoretical and empirical investigation. New York: National Bureau of Economic Research. http://www.measuredhs.com/pubs/pdf/CR26/CR26.pdf.
Initiative for Maternal Mortality Programme Assessment (IMMPACT): Implementation of free delivery policy in Ghana. University of Aberdeen; 2005. http://www.immpact-international.orgwebcite.
Initiative for Maternal Mortality Programme Assessment (IMMPACT): Implementation of free delivery policy in Ghana. University of Aberdeen; 2005. http://www.immpact-international.org.
Kistiana, S. (2009). Socio-economic and demographic determinants of maternal health care utilization in Indonesia. Unpublished master’s thesis, Flinders University of South Australia.
Lozano R, Wang H, Foreman KJ, Rajaratnam JK, Naghavi M, Marcus JR, Dwyer-Lindgren L, Lofgren KT, Phillips D, Atkinson C, Lopez AD, Murray CJL. Progress toward Millenium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. The Lancet.2011; 378: 1139-65.
Lwelamira and Safari: Choice of Place for Childbirth: Prevalence and Determinants of Health Facility Delivery among Women in Bahi District, Central Tanzania. Asian Journal of Medical Sciences 4(3): 105-112, 2012.
Magadi MA, Madise NJ, Rodrigues RN: Frequency and timing of antenatal care in Kenya: explaining the variations between women of different communities. J Soc S ci 2000, 51: 551 – 561Maryland, USA: ICFMacro. 2011.
Mekonnen, Y. and Mekonnen, A. (2003), “Factors inﬂuencing the use of maternal health care services in Ethiopia”, Journal of Health, Population and Nutrition, Vol. 21 No. 4, pp. 374-82.
Mensah, J. Oppong-Koranteng, R., Frempah-Yeboah, K, 2006. “Understanding Economic Reforms: the Case of Ghana” In Joseph Mensah (ed.) Understanding Economic Reforms in Africa: A Tale of Seven Nations (Basingstoke, Hampshire: Palgrave), p. 95-130.
Ministry of Health (MoH): Annual report 2010. Ghana: Accra; 2010.
Ministry of Health (MoH): Annual report 2012. Ghana: Accra; 2012.
Mpembeni, et al. (2007). Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: Implications for achievement of MDG-5 targets. Bio Medical Central, Pregnancy and Childbirth, 7(29). Retrieved November 2013, from www.biomedcentral.com/bmcpregnancychildbirth.
Navaneetham, K. and Dharmalingam, A. (2002), “Utilization of maternal health care services in Southern India”, Social Science & Medicine, Vol. 55, pp. 1849-69.
Nketiah-Amponsah, E., andSagoe-Moses, I. (2009). Expectant mothers and the demand for institutional delivery: Do household income and access to health information matter?-Some insight from Ghana. European Journal of Social Sciences, 8. Retrieved November 2013, from www.eurojournals.com/ejss.
Oppong, J. R. 2001. “Structural adjustment and the health care system” in Kwadwo Konadu-Agyemang (ed.), IMF and World Bank Sponsored Structural Adjustment.
Overbosch, et al.: Determinants of antenatal care use in Ghana. J Afr Econ 2004, 13: 277-301.
Owoo and Lambon-Quayefio (2013): National health insurance, social influence and antenatal care use in Ghana. Health Economics Review 2013, 3: 19.
Reproductive and Child Health Unit (Family Health Division), Public Health Department-Ghana Health Service (RCH/PHD-GHS): Annual Report 2010. Ghana: Accra; 2010.
United Nations. The Millenium Development Goals Report 2011. Available at: http://www.un.org/millenniumgoals/11_MDG%20Report_EN.pdf.
Van Eijk, A., H. Bles, F. Odhiambo, J. Ayisi, I. Blokland, D. Rosen, K. Adazu, L. Slutsker and K. Lindblade, (2006). Use of antenatal services and delivery care among women in rural Western Kenya: A community based survey. J. Reprod. Health, 3(2): 1-9.
WHO: Antenatal Care Department of Technical Working Group 2008 WHO/FRIt/msm/968; 2008.
WHO: The World Health Report 2011, Health systems: improving performance. Geneva: World Health Organization; 2011.
WHO: The World Health Report 2012, Health systems: improving performance. Geneva: World Health Organisation; 2012.
Wong, E. L., Popkin, B. M., Guilkey, D. K. and Akin, J. S. (1987), “Accessibility, quality of care and prenatal care use in the Philippines”, Social Science and Medicine, Vol. 24 No. 11, pp. 927-44.
World Health Organisation. (2013). World health statistics: Indicator compendium. Geneva: World Health Organisation.
World Health Organization (WHO). Maternal mortality fact sheet 2008.