Impact of Free Delivery Care on Health Facility Delivery and Insurance Coverage in Ghana’s Brong Ahafo Region

• DOI: 10.1371/journal.pone.0049430
• Publication Date: 2012-11-16T22:10:57Z
• Authors: Susie Dzakpasu; Seyi Soremekun; Alexander Manu; Guus ten Asbroek; Charlotte Tawiah; Lisa Hurt; Justin Fenty; Seth Owusu-Agyei; Zelee Hill; Oona M. R. Campbell; Betty R. Kirkwood
• Keywords: Economics; Science; Population; Social Sciences; Nursing; FOS: Health sciences; Ghana; Insurance Coverage; 03 medical and health sciences; 0302 clinical medicine; Pregnancy; Health Sciences; Humans; Business; 10. No inequality; Economic growth; Global Maternal and Child Health Outcomes; Maternal and Child Nutrition in Developing Countries; Nutrition and Dietetics; Q; R; Health care; 1. No poverty; Health Service Utilization; Health policy; Health services; 3. Good health; Economics, Econometrics and Finance; Environmental health; Socioeconomic Factors; Socioeconomics; Financing of Health Care Systems and Universal Coverage; Pediatrics, Perinatology and Child Health; Socioeconomic status; 8. Economic growth; Medicine; Female; Health Facilities; Delivery of Health Care; Finance; Research Article; Health facility

Background Many sub-Saharan countries, including Ghana, have introduced policies to provide free medical care pregnant women. The impact of these policies, particularly on access health services among the poor, has not been evaluated using rigorous methods, and so empirical basis for defending is weak. In a recent report also cast doubt current mechanism delivering – National Health Insurance Scheme. Longitudinal surveillance data from two randomized controlled trials conducted in Brong Ahafo Region provided unique opportunity assess Ghana’s policies. Methods We used time-series methods 2005 policy delivery its 2008 national insurance estimated their impacts facility coverage, socioeconomic differentials outcomes after controlling temporal trends seasonality. Results Facility increasing significantly over time. were associated with significant jumps coverage 2.3% (p = 0.015) 7.5% (p<0.001), respectively introduced. jumped (17.5%, p<0.001) policy. increases greatest poorest, leading decline inequality both outcomes. Conclusion Providing care, through insurance, effective overall Region, especially poor. This finding should be considered when evaluating Scheme supporting continuation expansion care.