The Impact of the National Health Insurance Scheme on Maternal Health Care in Ghana.

Despite significant gains in reducing maternal and infant mortalities across the world, Low and Middle-Income Countries continue to struggle in ensuring proper health care for mothers and children. To achieve the Sustainable Development Goals 3 of enhancing quality health care for women and children, the World Health Organization (WHO) admonishes countries to guarantee universal health coverage for their citizenry. Universal health coverage among other things, helps in alleviating the financial burden of women in accessing better health care during pregnancy and after childbirth. It is in light of this that countries including Ghana introduced the free maternal health policy under National Health Insurance Scheme (NHIS) to provide free maternal services for expectant and lactating mothers. Using interrupted time series analysis (itsa), this study examined any improvement at the national and regional levels, in delivery assistance by skilled birth attendants and postnatal care before and after the implementation of the free maternal health care within the NHIS. Findings from the study indicate that the NHIS had improved supervised deliveries by skilled birth attendants in all the 10 Ghanaian regions except for postnatal care. A greater number of NHIS-insured women utilized the services of skilled birth attendants during delivery after the commencement of the NHIS, unlike women with no insurance with the NHIS. On the contrary, the NHIS had no statistical association, nationally and in the 3 out of 10 regions, with postnatal care, despite an uptick post-NHIS, which suggests that a higher number of NHIS non-insured women received postnatal care compared to NHIS-insured women. With national and regional variations in maternal health care, the study brings to the fore, the need to increase enrollment in the NHIS and also identify and address other challenges affecting health care utilization such as long distances to health care centers, long waiting times at health facilities, unmotorable roads networks, which tend to undermine access to affordable health care for mothers and children