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The Association Between Health Insurance Coverage and Skilled Birth Attendance in Ghana: A National Study

Maternal and Child Health Journal volume 20, pages 534–541 (2016)Cite this article

Abstract

Objectives Skilled birth attendance (SBA) is a key health intervention used by roughly two-thirds of women in Ghana. The National Health Insurance Scheme provided by the Government of Ghana is widely expected to improve maternal health outcomes by removing financial barriers to health services. In this paper, we examine if indeed health insurance is able to improve SBA, a key maternal outcome. Methods We use data from the 2011 Ghana Multiple Indicator Cluster Survey implemented by the Ghana Statistical Services with support from the United Nations Children’s Fund (UNICEF). We use a multivariate logistic model controlling for a number of enabling and predisposing factors and past experience with the health system to examine the effect of health insurance on skilled birth attendance. The sample is 2528 women. Results Our results show that women with health insurance are 47 % more likely to use SBA than women without health insurance. Results also underscore that women with repetitive contact with the health system (such as antenatal care) are more likely to have a skilled delivery (OR 3.00, p value 0.000). We also find that higher parity, rural and poor women are much less likely to use SBA. Conclusions Health insurance may indeed be a useful mechanism to improve coverage of SBA, though many barriers to delivery care still exist for women. Further work to understand the effect of health insurance on other maternal outcomes is also warranted.

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Author information

Authors and Affiliations

  1. Data and Analytics Section, Division of Data, Research and Policy, United Nations Children’s Fund (UNICEF), Three United Nations Plaza, New York, NY, 10017, USA

    Shane M. Khan

  2. Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Shane M. Khan & Kavita Singh

  3. Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Kavita Singh

Authors
  1. Shane M. Khan
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  2. Kavita Singh
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Correspondence to Shane M. Khan.

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Khan, S.M., Singh, K. The Association Between Health Insurance Coverage and Skilled Birth Attendance in Ghana: A National Study. Matern Child Health J 20, 534–541 (2016). https://doi.org/10.1007/s10995-015-1851-6

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  • DOI: https://doi.org/10.1007/s10995-015-1851-6

Keywords

  • Health insurance
  • Skilled delivery
  • Ghana
  • Antenatal care
  • Continuum of care
  • Multiple Indicator Cluster Surveys