Free maternal health care policy in ghana pdf

Responses from women and health workers in akropong article pdf available december 2015 with 1,733 reads how we measure reads. The implementation of the free maternal health policy in. The effect of kenyas free maternal health care policy on. Under the policy, women are entitled to free services throughout pregnancy and at childbirth. Again, the nhis policy induces utilization of facility delivery services. The effects of ghanas national health insurance scheme on.

In ghana, there has been a steady increase in the number of facilitybased deliveries from about 300,000 in 2007 to. 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. However, womens unawareness of free maternal health service, especially among vulnerable groups negatively influences the utilization of healthcare. The operations of the free maternal care policy and out of pocket payments during. Implementation of the free maternity services policy and its. Ghanas free delivery care policy pubmed central pmc. Commonly referred to as the cash and carry system, this policy led to a reduction in utilisation of. Under this new health agenda, pregnant women across nigeria are expected to enjoy free maternal and delivery services at the primary health care phc level. These relationships are very strong even after controlling for variables such as wealth and the free maternal health care policy. Guiding principles for the child health policy 7 4. Institutional maternal mortality rate has reduced from 216 per 100,000 live births in 1990 to 164 per 100,000 live births in. Effectiveness of a free maternal healthcare programme under. This is a case investigation of a maternal death in rural ghana that seeks to unravel the circumstances that lead.

Although integration with maternal health can take place at several points, special focus will be placed on the dangerous period from labour and delivery through the first week of life. User fees are, however, important sources of income for health facilities and their removal has implications for the way in which health facilities are governed. Objective to explore how implementation of kenyas financing policy. But transport cost is reported to be a major cost driver for the use of maternal health services 21, 26. The policy covered delivery services in public, private and faithbased health facilities. Policy documents ministry of health ghana official website. Has the free maternal health policy eliminated out of. Though maternal health care has improved over the past 20 years, the pace has been slow and extra effort is required for ghana to achieve the mdg 5 target of reducing maternal mortality rate by three quarters by 2015. 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. Policy work can help accelerate gains in maternal health by strengthening health systems and improving access to highquality maternal health services before. Implementation of feefree maternal healthcare policy in ghana. The free delivery care policy covered antenatal care, normal deliveries, management of assisted and surgical deliveries. A statistically significant increase in facility deliveries was observed in kenya following the implementation of the free maternal health care policy in 20.

A research conducted by the navrongo health research centre nhrc shows that the governments free maternal health care policy is not working in the upper east region. Ghana s universal health care system has been described as the most successful healthcare system on the african continent by the renowned business magnate and tycoon bill gates. The case of new juaben municipality, eastern region. The study investigates the effect of ghana s national health insurance scheme nhis on health care utilisation. Ghana national newborn health strategy and action plan 20142018. 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. The policy sought to eliminate out of pocket oop payments and enhance the utilisation of maternal health services. Finally, the nhis policy proves to be a reliable factor to induce utilization of facility. Ghana is currently working towards achievement of the millennium development goals.

Information about the ghana maternal health survey 2007 may be obtained from icf macro formerly macro international inc. A free maternal health policy was implemented in ghana in july 2008 under the national health insurance scheme nhis. Ghana national newborn health strategy and action plan. In the case of the free maternal health policy the usaidfunded health policy project hpp provided. Access and utilization of maternal healthcare in a rural. We conducted three in depth interviews with healthcare staff as well as a focused group discussion comprising of six relatives of the deceased. Free maternal care policy and utilisation of maternal care services. We provide a short history of health insurance in ghana, and briefly discuss general patterns of enrolment in ghana as well as in accra in. Pdf implementation of feefree maternal healthcare policy.

Free maternal care policy and utilisation of maternal care. Pdf implementation of feefree maternal healthcare policy in. Ghana 3 ghana maternal and newborn health disparities in 2015, 884,000 babies were born in ghana, or around 2,400 every day. Using nationally representative data from the demographic and health surveys dhs, this paper assesses the impact of health insurance on use of antenatal care and facilitybased delivery care in.

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. In ghana, the benefit package of the nhis does not cover the cost of transport and thus pregnant women and expectant mothers would have to pay for transport to and from health facilities under the free maternal care policy. May 29, 2018 a free maternal health policy was implemented in ghana in july 2008 under the national health insurance scheme nhis. Ghanas national health insurance scheme nhis was created by the national health insurance act of august 2003, and is one of very few attempts by a subsaharan african country to implement a nationallevel, universal health insurance program. This article presents an exploratory qualitative analysis of how the policy of free. In response to poor performance on maternal health, the ministry of health developed the ghana mdg millennium. An exploratory study of the policy process and early. During the same year, free membership was made available to all children under18.

Pdf national health insurance and free maternal healthcare in. The implementation of the free maternal health policy in rural. Implementation of feefree maternal healthcare policy in. 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. Free maternal health care policy and access to supervised care at.

In 2007, the free delivery care policy was formally ended due to lack of funding and integrated into the nhis, which was already functional since 2005 witter and garshong 2009. Determinants of antenatal healthcare utilisation by. The study is intended to improve policy formulation and assist the nhia to evaluate the impact of the free maternal healthcare policy based on utilization of maternal care services as a measurement of success or failure in improving maternal health in ghana. The effect of ghanas national health insurance scheme on. Introduction the free maternal health policy was implemented in ghana in 2008 under the national health insurance scheme nhis. In kenya, more than 6 000 maternal deaths, and 35 000 stillbirths occur each year. Child health is a major public health and development challenge in ghana. Effectiveness of a free maternal healthcare programme.

Introduction to move towards universal health coverage, the government of kenya introduced free maternity services in all public health facilities in june 20. 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. It is of this view that the ghana ministry of health introduced the free maternal healthcare delivery nationwide in april 2005 of which antenatal care was a major component. National health insurance and free maternal healthcare in ghana. Despite this, progress in achieving maternal health targets has been slow, with 90 percent of countries not on track to achieve the millennium development goal for maternal health mdg 5. Some research, however, has reported mixed findings regarding the impact of health insurance on the use of maternal health care. Perspectives of users of antenatal and delivery care services from public health care facilities in accra. Several other studies have also demonstrated a positive association between use of maternal health care and health insurance coverage, but with less rigorous methodology smith and sulzbach 2008. Implementation of the free maternity services policy and. The objective is to eliminate financial barriers associated with the use of services. 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.

The free maternal health policy introduced under nhis has led to increased use of health services by pregnant women in ways that have increased pressure on existing human resources. Two decades of maternity care fee exemption policies in. The operations of the free maternal care policy and out of. In this issue we publish articles resulting from an evaluation of ghanas 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. We exploit data on births before and after the intervention and apply propensity score matching to limit the bias. The study explored views on costs and actual oop payments during pregnancy. Impact of nhis free maternal healthcare policy on utilization. The study investigates the effect of wealth on maternal health care utilization in ghana via its effect on antenatal care use. Antenatal care serves as the initial point of contact of expectant mothers to maternal health care providers before delivery. Setting we conducted a crosssectional quantitative study involving household. Ghanas national health insurance, free maternal healthcare and. It is suggested that the government of ghana, the health insurance scheme and other stakeholders improve the provision of resources to. Has the free maternal health policy eliminated out of pocket.

Objectives in her quest to reduce maternal mortality, ghana introduced a free maternal healthcare programme under the national health insurance scheme. Technical support such policy changes aim to promote the health of all kenyans, and are best implemented with careful analyses of options and costs. Two decades of maternity care fee exemption policies in ghana. Effectiveness of a free maternal healthcare programme under the. The study also concludes that ghana s fmh policy has improved both nhis enrolment and the use of facility delivery services. 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. In june, 20, the government of kenya abolished user fees for maternity care in all public health facilities under the free maternity service fms policy, to make maternity services accessible and affordable, and to reduce maternal and perinatal deaths. The lifetime risk of maternal death is more than 200 times greater for women in poor countries compared to women in western europe and north america who. Additional information may be obtained from the ghana statistical service, p. The effect of kenyas free maternal health care policy on the.

The free maternal health policy was implemented in ghana in 2008. 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. Ghanas national health insurance, free maternal healthcare. Kmc kangaroo mother care ma medical assistant mch maternal and child health mda minimum daily allowance. Pdf national health insurance and free maternal healthcare. In ghana, uptake of skilled attendance at childbirth is a challenge, especially for. 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. To promote skilled attendance at births and reduce maternal deaths, the government of ghana introduced the free maternal care policy under the national health insurance scheme nhis in 2008. Ghanas free maternal healthcare policy not working.

A free maternal health policy was implemented under ghanas national health insurance scheme to promote the use of maternal health services. The case of new juaben municipality, eastern region, ghana ameyaw, emmanuel asante on. Increasing equitable access to health care is a main challenge african policy makers are facing. Universal health coverage, free maternal care policy, fee exemption, out of pocket. Pregnant women were offered free access to health care through national health insurance nhis membership in ghana in 2008, in the latest phase of policy reforms to ensure universal access to maternal health care. This article presents an exploratory qualitative analysis of how the policy of free maternal. These economic conditions make the choices of how to use ghanas scarce resources to positively affect health care all the more important. But studies elsewhere showed that out of pocket oop payments still exist in the midst of fee exemptions. Mar 18, 2020 these relationships are very strong even after controlling for variables such as wealth and the free maternal health care policy. Undoubtedly, free maternal healthcare increases access and utilization.

The operations of the free maternal care policy and out of pocket. Pdf the government of ghana from the 1990s has tried a lot of policies to finance healthcare in ghana. The cost of health care and perceived low quality of care by the public have been argued to be the reason for the poor utilisation of maternal and child health services in nigeria. The evaluation of the free maternal health care initiative in ghana follows almost five years after it was launched in 2008. To evaluate the impact of the mohs free maternal health care policy on utilisation of skilled delivery services in ghana. Perspectives of users of antenatal and delivery care services from public healthcare facilities in accra patricia anafi, wisdom k. 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. Improving maternal healthcare remains a major public health concern globally but particularly in subsaharan africa. In the context of global maternal and child health priorities abouzahr 2003, there is a growing need to evaluate whether health insurance has contributed to greater use of maternal health care. This result is similar to observations of the implementation of free maternal health care policies in other african countries 24,25,26,27.

The study also concludes that ghanas fmh policy has improved both nhis enrolment and the use of facility delivery services. Developed with support from the usaidfunded health policy project, a guide for advocating for respectful maternity care is a comprehensive resource centered on the respectful maternity care charter, a groundbreaking consensus document that demonstrates the legitimate place of maternal health rights within the broader context of human rights. The ghanaian government implemented the national health insurance scheme in 2004 and the aim of this study is to evaluate its early effects on maternal and infant healthcare use. However, effective and timely antenatal care anc has the capacity to. This is a case investigation of a maternal death in rural ghana that seeks to unravel the circumstances that lead to her death. The policy is expected to reduce the cost on maternal services which serves as a burden to pregnant mothers and reduces maternal mortality rate. To achieve the targets for the reduction of child mortality, which forms mdg 4, ghana should reduce underfive deaths per 1,000 live births to 43, and increase measles immunisation to 100 per cent by 2015. Determinants of antenatal healthcare utilisation by pregnant.

It is unclear whether the policy had altered oop payments for services. Implementation of fee free maternal health care policy in ghana. Free maternal health care policy and access to supervised. Technical interventions along the continuum of care 8 5. Maternal mortality remains a challenge in providing quality maternal and other reproductive healthcare services in ghana.