Impact of Ghana’s fee exemption policy on maternal health service utilisation: an inverse probability of treatment weighting analysis of pooled national data

• DOI: 10.7189/jogh.15.04058
• Publication Date: 2025-02-21T10:36:16Z
• Authors: Kennedy Mensah Osei; Andreana Ayiilabo...; Danik Iga Prasiska; Durga Datta Chapa...; Min Jin Ha
• Keywords: Odds; User fee

Fee exemption policies are key strategies for reducing the barriers to accessing maternal health services and improving child outcomes. This study used pooled national data determine impact of Ghana's user fee policy on service utilisation since it was implemented in 2008. Using four rounds cross-sectional from surveys women with live births, we conducted an inverse probability treatment weighting analysis evaluate causal effects intervention timing first antenatal care (ANC) visit, completion or more ANC visits facility-based delivery as indicators utilisation. The average effect increase 8, 9, 21% timely recommended number visits, delivery, respectively. Wealth index categorisation showed a clear stepwise likelihood delivery. Compared poorest group, odds were 1.48 times higher poorer group adjusted ratio (aOR) = (95% confidence interval (CI) 1.33-1.66), 2.27 middle aOR CI 1.95-2.64), 3.84 rich 3.13-4.69), 5.96 richest 4.43-8.02). Women who reside Upper East region likely utilise services. positively impacts among pregnant women. However, there still exist disparities across geographical regions wealth indexes.