Effect of Ghana’s National Health Insurance Scheme on maternal healthcare use

Background The government of Ghana introduced a National Health Insurance Scheme (NHIS) in 2003 to improve the access to health facilities and reduce the financial burden of out-of-pocket health expenditures. This study evaluates the effect of NHIS enrollment on maternal healthcare use. Methods We use data from the Ghana Demographic and Health Survey of 2008 and regression and propensity score matching techniques to measure the effect of NHIS enrollment on the use of antenatal and delivery care. We also explore heterogeneity of effects across poverty status. Results Our findings suggest that women enrolled with the NHIS are more likely to receive at least 4 antenatal care visits by a specialist (9.6 percentage points), an institutionalized delivery (11.4 percentage points) and child birth by caesarean (3.4 percentage points). Furthermore we found a difference in the enrollment effect to receive a caesarean birth between poor people. Conclusion We conclude that NHIS enrollment has important positive effects on the use of maternal health care and will realize improvements in maternal health outcomes, especially for the poor.