An assessment of out of pocket payments in public sector health facilities under the free maternal healthcare policy in Ghana

Maxwell Tii Kumbeni (), Agani Afaya and Paschal Awingura Apanga
Additional contact information
Maxwell Tii Kumbeni: Oregon State University
Agani Afaya: Yonsei University
Paschal Awingura Apanga: Kentucky Department for Public Health

Health Economics Review, 2023, vol. 13, issue 1, 1-7

Abstract: Abstract Background The free maternal healthcare policy was introduced in Ghana in 2008 under the national health insurance scheme as a social intervention to improve access to maternal health services. This study investigated the prevalence of out of pocket (OOP) payment among pregnant women with valid national health insurance who sought skilled delivery services at public sector health facilities in Ghana. The study also assessed the health system factors associated with OOP payment. Methods We used data from the Ghana Maternal Health Survey (GMHS), which was conducted in 2017. The study comprised 7681 women who delivered at a public sector health facility and had valid national health insurance at the time of delivery. We used multivariable logistic regression analysis to assess factors associated with OOP payment, whiles accounting for clustering, stratification, and sampling weights. Results The prevalence of OOP payment for skilled delivery services was 19.0%. After adjustment at multivariable level, hospital delivery services (adjusted Odds Ratio [aOR] = 1.23, 95% Confidence Interval [CI] = 1.00, 1.52), caesarean section (aOR = 1.73, 95% CI = 1.36, 2.20), and receiving intravenous infusion during delivery (aOR = 1.31, 95% CI = 1.08, 1.60) were associated with higher odds of OOP payment. Women who were discharged home 2 to 7 days after delivery had 19% lower odds of OOP payment compared to those who were discharged within 24 hours after delivery. Conclusion This study provides evidence of high prevalence of OOP payment among women who had skilled delivery services in public sector health facilities although such women had valid national health insurance. Government may need to institute measures to reduce OOP payment in public sector facilities especially at the hospitals and for women undergoing caesarean sections.

Keywords: Free maternal healthcare policy; National health insurance scheme; Out of pocket payment; Skilled delivery services; Public sector health facilities; Health system factors; Ghana (search for similar items in EconPapers)
Date: 2023
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
http://link.springer.com/10.1186/s13561-023-00423-0 Abstract (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:spr:hecrev:v:13:y:2023:i:1:d:10.1186_s13561-023-00423-0

Ordering information: This journal article can be ordered from
http://www.springer.com/journal/13561

DOI: 10.1186/s13561-023-00423-0

Access Statistics for this article

Health Economics Review is currently edited by J. Matthias Graf von der Schulenburg

More articles in Health Economics Review from Springer
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().