Health insurance determines antenatal, delivery and postnatal care utilisation: evidence from the Ghana Demographic and Health Surveillance data

Joyce L Browne; Gbenga A Kayode; Daniel Arhinful; Samuel A J Fidder; Diederick E Grobbee; Kerstin Klipstein-Grobusch

doi:10.1136/bmjopen-2015-008175

Health insurance determines antenatal, delivery and postnatal care utilisation: evidence from the Ghana Demographic and Health Surveillance data

Joyce L Browne, Gbenga A Kayode, Daniel Arhinful, Samuel A J Fidder, Diederick E Grobbee, Kerstin Klipstein-Grobusch

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Abstract

OBJECTIVE: This study aims to evaluate the effect of maternal health insurance status on the utilisation of antenatal, skilled delivery and postnatal care.

DESIGN: A population-based cross-sectional study.

SETTING AND PARTICIPANTS: We utilised the 2008 Demographic and Health Survey data of Ghana, which included 2987 women who provided information on maternal health insurance status.

PRIMARY OUTCOMES: Utilisation of antenatal, skilled delivery and postnatal care.

STATISTICAL ANALYSES: Multivariable logistic regression was applied to determine the independent association between maternal health insurance and utilisation of antenatal, skilled delivery and postnatal care.

RESULTS: After adjusting for socioeconomic, demographic and obstetric factors, we observed that among insured women the likelihood of having antenatal care increased by 96% (OR 1.96; 95% CI 1.52 to 2.52; p value<0.001) and of skilled delivery by 129% (OR 2.29; 95% CI 1.92 to 2.74; p value<0.001), while postnatal care among insured women increased by 61% (OR 1.61; 95% CI 1.17 to 2.21; p value<0.01).

CONCLUSIONS: This study demonstrated that maternal health insurance status plays a significant role in the uptake of the maternal, neonatal and child health continuum of care service.

Original language	English
Article number	e008175
Journal	BMJ open [E]
Volume	6
Issue number	3
DOIs	https://doi.org/10.1136/bmjopen-2015-008175
Publication status	Published - 2016

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title = "Health insurance determines antenatal, delivery and postnatal care utilisation: evidence from the Ghana Demographic and Health Surveillance data",

abstract = "OBJECTIVE: This study aims to evaluate the effect of maternal health insurance status on the utilisation of antenatal, skilled delivery and postnatal care.DESIGN: A population-based cross-sectional study.SETTING AND PARTICIPANTS: We utilised the 2008 Demographic and Health Survey data of Ghana, which included 2987 women who provided information on maternal health insurance status.PRIMARY OUTCOMES: Utilisation of antenatal, skilled delivery and postnatal care.STATISTICAL ANALYSES: Multivariable logistic regression was applied to determine the independent association between maternal health insurance and utilisation of antenatal, skilled delivery and postnatal care.RESULTS: After adjusting for socioeconomic, demographic and obstetric factors, we observed that among insured women the likelihood of having antenatal care increased by 96% (OR 1.96; 95% CI 1.52 to 2.52; p value<0.001) and of skilled delivery by 129% (OR 2.29; 95% CI 1.92 to 2.74; p value<0.001), while postnatal care among insured women increased by 61% (OR 1.61; 95% CI 1.17 to 2.21; p value<0.01).CONCLUSIONS: This study demonstrated that maternal health insurance status plays a significant role in the uptake of the maternal, neonatal and child health continuum of care service.",

author = "Browne, {Joyce L} and Kayode, {Gbenga A} and Daniel Arhinful and Fidder, {Samuel A J} and Grobbee, {Diederick E} and Kerstin Klipstein-Grobusch",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/",

year = "2016",

doi = "10.1136/bmjopen-2015-008175",

language = "English",

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journal = "BMJ open [E]",

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T2 - evidence from the Ghana Demographic and Health Surveillance data

AU - Browne, Joyce L

AU - Kayode, Gbenga A

AU - Arhinful, Daniel

AU - Fidder, Samuel A J

AU - Grobbee, Diederick E

AU - Klipstein-Grobusch, Kerstin

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

PY - 2016

Y1 - 2016

N2 - OBJECTIVE: This study aims to evaluate the effect of maternal health insurance status on the utilisation of antenatal, skilled delivery and postnatal care.DESIGN: A population-based cross-sectional study.SETTING AND PARTICIPANTS: We utilised the 2008 Demographic and Health Survey data of Ghana, which included 2987 women who provided information on maternal health insurance status.PRIMARY OUTCOMES: Utilisation of antenatal, skilled delivery and postnatal care.STATISTICAL ANALYSES: Multivariable logistic regression was applied to determine the independent association between maternal health insurance and utilisation of antenatal, skilled delivery and postnatal care.RESULTS: After adjusting for socioeconomic, demographic and obstetric factors, we observed that among insured women the likelihood of having antenatal care increased by 96% (OR 1.96; 95% CI 1.52 to 2.52; p value<0.001) and of skilled delivery by 129% (OR 2.29; 95% CI 1.92 to 2.74; p value<0.001), while postnatal care among insured women increased by 61% (OR 1.61; 95% CI 1.17 to 2.21; p value<0.01).CONCLUSIONS: This study demonstrated that maternal health insurance status plays a significant role in the uptake of the maternal, neonatal and child health continuum of care service.

AB - OBJECTIVE: This study aims to evaluate the effect of maternal health insurance status on the utilisation of antenatal, skilled delivery and postnatal care.DESIGN: A population-based cross-sectional study.SETTING AND PARTICIPANTS: We utilised the 2008 Demographic and Health Survey data of Ghana, which included 2987 women who provided information on maternal health insurance status.PRIMARY OUTCOMES: Utilisation of antenatal, skilled delivery and postnatal care.STATISTICAL ANALYSES: Multivariable logistic regression was applied to determine the independent association between maternal health insurance and utilisation of antenatal, skilled delivery and postnatal care.RESULTS: After adjusting for socioeconomic, demographic and obstetric factors, we observed that among insured women the likelihood of having antenatal care increased by 96% (OR 1.96; 95% CI 1.52 to 2.52; p value<0.001) and of skilled delivery by 129% (OR 2.29; 95% CI 1.92 to 2.74; p value<0.001), while postnatal care among insured women increased by 61% (OR 1.61; 95% CI 1.17 to 2.21; p value<0.01).CONCLUSIONS: This study demonstrated that maternal health insurance status plays a significant role in the uptake of the maternal, neonatal and child health continuum of care service.

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DO - 10.1136/bmjopen-2015-008175

M3 - Article

C2 - 26993621

SN - 2044-6055

VL - 6

JO - BMJ open [E]

JF - BMJ open [E]

IS - 3

M1 - e008175

ER -

Health insurance determines antenatal, delivery and postnatal care utilisation: evidence from the Ghana Demographic and Health Surveillance data

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